Provider Demographics
NPI:1437232436
Name:TECLER, RONALD STUART (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:STUART
Last Name:TECLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 GUY PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-3238
Mailing Address - Country:US
Mailing Address - Phone:518-842-7830
Mailing Address - Fax:518-843-5162
Practice Address - Street 1:191 GUY PARK AVENUE
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-842-7830
Practice Address - Fax:518-843-5162
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0261411122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist