Individual
DR. MYLES DENNIS TETEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
476 WATER ST, PRAIRIE DU SAC, WI 53578-1127
(608) 643-3855
(608) 643-6295
Mailing address
476 WATER ST, P.O. BOX 126, PRAIRIE DU SAC, WI 53578-1127
(608) 643-3855
(608) 643-6295
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4611-015
WI
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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