Provider Demographics
NPI:1770845117
Name:PAUL TEED
Entity Type:Organization
Organization Name:PAUL TEED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:TEED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-268-5371
Mailing Address - Street 1:204 S CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6840
Mailing Address - Country:US
Mailing Address - Phone:501-268-5371
Mailing Address - Fax:501-268-8998
Practice Address - Street 1:1113 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7318
Practice Address - Country:US
Practice Address - Phone:501-268-5371
Practice Address - Fax:501-268-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty