Provider Demographics
NPI:1073622296
Name:LOVELACE, TERI (DDS, MS, PA)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:DDS, MS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3281 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6221
Mailing Address - Country:US
Mailing Address - Phone:325-695-1131
Mailing Address - Fax:325-695-7771
Practice Address - Street 1:3281 S 27TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6221
Practice Address - Country:US
Practice Address - Phone:325-695-1131
Practice Address - Fax:325-695-7771
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics