Provider Demographics
NPI:1700023850
Name:TERESA ISBELL DDS INC
Entity Type:Organization
Organization Name:TERESA ISBELL DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-888-1167
Mailing Address - Street 1:291 GRASS VALLEY HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4533
Mailing Address - Country:US
Mailing Address - Phone:530-888-1167
Mailing Address - Fax:
Practice Address - Street 1:291 GRASS VALLEY HWY
Practice Address - Street 2:SUITE B
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4533
Practice Address - Country:US
Practice Address - Phone:530-888-1167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51608261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental