Provider Demographics
NPI:1801374871
Name:STEPHANIE W TEICHMILER DMD PC
Entity Type:Organization
Organization Name:STEPHANIE W TEICHMILER DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:TEICHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-350-5820
Mailing Address - Street 1:1316 SOMERVILLE RD SE STE 2
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4309
Mailing Address - Country:US
Mailing Address - Phone:256-350-5820
Mailing Address - Fax:256-353-3117
Practice Address - Street 1:1316 SOMERVILLE RD SE STE 2
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4309
Practice Address - Country:US
Practice Address - Phone:256-350-5820
Practice Address - Fax:256-353-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4411261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental