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Individual

DR. TERESA PEREZ CAVNAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1028 EDGEWATER CORPORATE PKWY, INDIAN LAND, SC 29707-0107
(803) 835-2500
Mailing address
1604 CHURCHILL DOWNS DR, WAXHAW, NC 28173
(630) 391-1026

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7119
SC
1223G0001X
General Practice Dentistry
019.025077
IL
1223G0001X
General Practice Dentistry
10444
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9182559
IL
Enumeration date
03/02/2007
Last updated
01/27/2025
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