Provider Demographics
NPI:1609091487
Name:BRIGANCE, TERESA K (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:K
Last Name:BRIGANCE
Suffix:
Gender:F
Credentials:DMD MS
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Mailing Address - Street 1:3760 N WICKHAM RD
Mailing Address - Street 2:#1
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935
Mailing Address - Country:US
Mailing Address - Phone:321-242-9900
Mailing Address - Fax:321-242-4631
Practice Address - Street 1:3760 N WICKHAM RD
Practice Address - Street 2:#1
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-242-9900
Practice Address - Fax:321-242-4631
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLDN124381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics