Provider Demographics
NPI:1558525493
Name:TELLER, HUGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:
Last Name:TELLER
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 1:2202 N. BERKSHIRE RD. SUITE 202
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2761
Mailing Address - Country:US
Mailing Address - Phone:434-296-4012
Mailing Address - Fax:434-829-0025
Practice Address - Street 1:2202 N. BERKSHIRE RD. SUITE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2761
Practice Address - Country:US
Practice Address - Phone:434-296-4012
Practice Address - Fax:434-829-0025
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010075621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice