| David R. Tebbenkamp Dds Pc | |
| 
					21788 Azen Rd Damascus VA 24236-4236  | |
| (276) 388-3511 | |
| (276) 388-3163 | 
| Full Name | David R. Tebbenkamp Dds Pc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 21788 Azen Rd, Damascus, Virginia | 
| Authorized Official Name and Position | David Ray Tebbenkamp (DENTIST/PRESIDENT) | 
| Authorized Official Contact | 2763883511 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| David R. Tebbenkamp Dds Pc 21788 Azen Rd Damascus VA 24236-4236 Ph: (276) 388-3511  | David R. Tebbenkamp Dds Pc 21788 Azen Rd Damascus VA 24236-4236 Ph: (276) 388-3511  | 
| NPI Number | 1114127537 | 
|---|---|
| Provider Enumeration Date | 07/24/2007 | 
| Last Update Date | 07/24/2007 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1114127537 | NPI | - | NPPES | 
| 228633 | Other | VA | ANTHEM-BLUE CROSS BLUE SH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401004941 (Virginia) | Primary |