Provider Demographics
NPI:1700026770
Name:LADNER, TERESA (DDS)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:LADNER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13810 JOHN AUDUBON PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-3862
Mailing Address - Country:US
Mailing Address - Phone:281-486-9222
Mailing Address - Fax:281-486-8700
Practice Address - Street 1:13810 JOHN AUDUBON PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-3862
Practice Address - Country:US
Practice Address - Phone:281-486-9222
Practice Address - Fax:281-486-8700
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist