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Individual

DR. MOLLY ELIZABETH TEGERDINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
1001 W WORLEY ST, COLUMBIA, MO 65203-2037
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2013016375
MO
1223G0001X
General Practice Dentistry
2013016375
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
400042605
MO
Enumeration date
08/13/2013
Last updated
09/13/2022
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