Individual
TERESA S GENESER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2218 1ST AVE NE, CEDAR RAPIDS, IA 52402-6347
(319) 364-2413
(319) 364-8179
Mailing address
1962 1ST AVE NE, CEDAR RAPIDS PEDIATRIC DENTISTRY, CEDAR RAPIDS, IA 52402-5330
(319) 364-2413
(319) 364-8179
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
LD00035
RI
1223P0221X
Pediatric Dentistry
Primary
08795
IA
1223P0221X
Pediatric Dentistry
30288
IA
Other
Enumeration date
06/25/2008
Last updated
11/05/2019
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