Provider Demographics
NPI:1184833220
Name:TELTHORST, DEAN F (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:F
Last Name:TELTHORST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7937 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1369
Mailing Address - Country:US
Mailing Address - Phone:314-725-2232
Mailing Address - Fax:314-725-2790
Practice Address - Street 1:7937 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1369
Practice Address - Country:US
Practice Address - Phone:314-725-2232
Practice Address - Fax:314-725-2790
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0139331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice