Teagarden, Joel W

Teagarden, Joel W is an individual health care provider with primary practice located at 3520 Utica Ridge Rd , Bettendorf IA 52722. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Teagarden, Joel W can be contacted via phone (563) 359-9165.

Contact Information

Primary practice address
3520 Utica Ridge Rd Bettendorf IA 52722
Fax: (563) 359-1824
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6110 Iowa

Profile Details

NPI number 1104862408
LBN Legal business name Teagarden, Joel W
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104862408 NPPES
Iowa MEDICAID 1131235
Iowa Other 6110

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