Individual
DR. GREGORY CHARLES TELLATIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1628 S. CAMPBELL, SPRINGFIELD, MO 65807-2002
(417) 862-0782
(417) 862-3866
Mailing address
1628 S. CAMPBELL, SPRINGFIELD, MO 65807
(417) 862-0782
(417) 862-3866
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14175
MO
Other
Enumeration date
10/05/2006
Last updated
02/23/2015
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