Provider Demographics
NPI:1750666962
Name:STITELER, TERESA C (DMD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:C
Last Name:STITELER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1264
Mailing Address - Country:US
Mailing Address - Phone:215-536-8111
Mailing Address - Fax:215-536-1615
Practice Address - Street 1:401 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1264
Practice Address - Country:US
Practice Address - Phone:215-536-8111
Practice Address - Fax:215-536-1615
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA024777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist