Provider Demographics
NPI:1811069024
Name:HOEF, TERESE (TERRI) ANN (RDH)
Entity type:Individual
Prefix:MRS
First Name:TERESE (TERRI)
Middle Name:ANN
Last Name:HOEF
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MISS
Other - First Name:TERESE (TERRI)
Other - Middle Name:ANN
Other - Last Name:KLARICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH
Mailing Address - Street 1:962 LONG BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-3137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 W LOSEY ST
Practice Address - Street 2:
Practice Address - City:SCOTT AIR FORCE BASE
Practice Address - State:IL
Practice Address - Zip Code:62225-5250
Practice Address - Country:US
Practice Address - Phone:618-256-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902005439124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist