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Individual

DR. TERESA HELEN CONNORS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
911 11TH AVE, SUITE D, LONGVIEW, WA 98632-2547
(360) 636-2100
(360) 636-2103
Mailing address
911 11TH AVE STE D, LONGVIEW, WA 98632-2546
(360) 636-2100
(360) 636-2103

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D6464
OR
122300000X
Dentist
Primary
DE00009712
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5045042
MEDICAL ASSISTANCE ADMIN
WA
Enumeration date
10/05/2005
Last updated
10/29/2019
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