| 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 |