Provider Demographics
NPI:1336598549
Name:TEYMOURI, CYRUS H (DDS)
Entity Type:Individual
Prefix:
First Name:CYRUS
Middle Name:H
Last Name:TEYMOURI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 MARKET CENTER DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8407
Mailing Address - Country:US
Mailing Address - Phone:636-300-4380
Mailing Address - Fax:636-300-0073
Practice Address - Street 1:1630 MARKET CENTER DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8407
Practice Address - Country:US
Practice Address - Phone:636-300-4380
Practice Address - Fax:636-300-0073
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016018484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist