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 |
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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 |
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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 |
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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 |