Provider Demographics
NPI:1740272293
Name:TEDFORD, TERRY ALAN (DDS)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:ALAN
Last Name:TEDFORD
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 1:7265 S UNIVERSITY BLVD
Mailing Address - Street 2:STE J
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122
Mailing Address - Country:US
Mailing Address - Phone:303-770-8278
Mailing Address - Fax:303-770-8279
Practice Address - Street 1:7562 S UNIVERSITY BLVD
Practice Address - Street 2:STE J
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3159
Practice Address - Country:US
Practice Address - Phone:303-770-8278
Practice Address - Fax:303-770-8279
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO05155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist