Provider Demographics
NPI:1245467182
Name:NESTOR, TERESA LYNN (RDH)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:NESTOR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:LYNN
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:140 N BEESON AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2937
Mailing Address - Country:US
Mailing Address - Phone:724-439-1628
Mailing Address - Fax:724-438-2274
Practice Address - Street 1:140 N BEESON AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2937
Practice Address - Country:US
Practice Address - Phone:724-439-1628
Practice Address - Fax:724-438-2274
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH070137124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist