Provider Demographics
NPI:1629232830
Name:WINCHESTER, TERRY W (DDS)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:W
Last Name:WINCHESTER
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 1:17447 KUYKENDAHL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8300
Mailing Address - Country:US
Mailing Address - Phone:281-379-1100
Mailing Address - Fax:281-379-1654
Practice Address - Street 1:17447 KUYKENDAHL RD
Practice Address - Street 2:SUITE C
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8300
Practice Address - Country:US
Practice Address - Phone:281-379-1100
Practice Address - Fax:281-379-1654
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist