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Individual
TYSON TEEPLES
Active
Individual
TYSON TEEPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D9701
OR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE60266972
WA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
60266972
WA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
D12473
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
D9701
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
06/13/2007
Last updated
11/25/2014
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