| Teddy H Spence, Dds, Pllc | |
| 
					3897 Main St Chincoteague Island VA 23336-1809  | |
| (757) 336-5116 | |
| (757) 336-2227 | 
| Full Name | Teddy H Spence, Dds, Pllc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 3897 Main St, Chincoteague Island, Virginia | 
| Authorized Official Name and Position | Ellen Kellam Spence (OFFICE MANAGER) | 
| Authorized Official Contact | 7573365116 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Teddy H Spence, Dds, Pllc 3897 Main St Chincoteague Island VA 23336-1809 Ph: (757) 336-5116  | Teddy H Spence, Dds, Pllc 3897 Main St Chincoteague Island VA 23336-1809 Ph: (757) 336-5116  | 
| NPI Number | 1013320688 | 
|---|---|
| Provider Enumeration Date | 06/11/2014 | 
| Last Update Date | 06/11/2014 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1013320688 | NPI | - | NPPES | 
| 1417977158 | Other | VA | NPI | 
| 0401005191 | Other | VA | DENTAL LICENSE | 
| 2136095645751 | Medicaid | VA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401005191 (Virginia) | Primary |