Provider Demographics
NPI:1225921588
Name:TAYLOR, GREGORY B II
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:B
Last Name:TAYLOR
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 ASPENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-8836
Mailing Address - Country:US
Mailing Address - Phone:404-786-6786
Mailing Address - Fax:
Practice Address - Street 1:3490 PIEDMONT RD NE STE 230
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-4810
Practice Address - Country:US
Practice Address - Phone:404-233-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN123782122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist