Provider Demographics
NPI:1346261781
Name:BARE, TERESA ELLIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ELLIS
Last Name:BARE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:E
Other - Last Name:BARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:168 WESTON RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-3109
Mailing Address - Country:US
Mailing Address - Phone:828-654-0257
Mailing Address - Fax:
Practice Address - Street 1:192 E CHESTNUT ST STE B
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2387
Practice Address - Country:US
Practice Address - Phone:828-255-0936
Practice Address - Fax:828-252-9434
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice