| 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 |