Individual
DR. SIDNEY CALVIN TEAGUE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2040 SOUTH STRATFORD RD, WINSTON SALEM, NC 27103
(336) 765-6315
Mailing address
2040 SOUTH STRATFORD RD, WINSTON SALEM, NC 27103
(336) 765-6315
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4260
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8998340
—
NC
Enumeration date
09/12/2007
Last updated
09/12/2007
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