Provider Demographics
NPI:1750455325
Name:TEEL, RICHARD S (RICHARD TEEL)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:TEEL
Suffix:
Gender:M
Credentials:RICHARD TEEL
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:S
Other - Last Name:TEEL, DDS PC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RICHARD TEEL
Mailing Address - Street 1:1460 COMMERCIAL ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4308
Mailing Address - Country:US
Mailing Address - Phone:503-581-1569
Mailing Address - Fax:503-363-0415
Practice Address - Street 1:1460 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4308
Practice Address - Country:US
Practice Address - Phone:503-581-1569
Practice Address - Fax:503-363-0415
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR53271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics