Provider Demographics
NPI:1770329278
Name:TEUBNER, SAXON BURTON (DDS)
Entity type:Individual
Prefix:
First Name:SAXON
Middle Name:BURTON
Last Name:TEUBNER
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 1:1528 FOX MOOR CT
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-9100
Mailing Address - Country:US
Mailing Address - Phone:573-691-7331
Mailing Address - Fax:
Practice Address - Street 1:2226 MISSOURI BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-4727
Practice Address - Country:US
Practice Address - Phone:573-658-4022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240197381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice