DR. TED DEATHERAGE, D.M.D.

Dentist

Active Individual
NPI: 1689721813

Practice Address

1616 GIBSON ST
West Plains, MO 65775

Phone: (417) 257-0126

Specialties

Specialty Code Primary License
Dentist 122300000X Yes DEA015659 (MO)

Frequently Asked Questions

NPI 1689721813 is the National Provider Identifier for DR. TED DEATHERAGE, D.M.D., a Dentist provider located in West Plains, MO. This NPI was enumerated on January 3, 2007.
DR. TED DEATHERAGE, D.M.D. practices at 1616 GIBSON ST, West Plains, MO 65775.

Quick Facts

NPI
1689721813
Type
Individual
Enumerated
Jan 3, 2007
Last Updated
Jul 8, 2007

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