Provider Demographics
NPI:1851407704
Name:TEICHMILLER, STEPHANIE W (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:W
Last Name:TEICHMILLER
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 1:1316 SOMERVILLE RD SE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-350-5820
Mailing Address - Fax:256-353-3117
Practice Address - Street 1:1316 SOMERVILLE RD SE
Practice Address - Street 2:SUITE 2
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4305
Practice Address - Country:US
Practice Address - Phone:256-350-5820
Practice Address - Fax:256-353-3117
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL44111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4411OtherSTATE DENTAL LICENSE