Individual
DR. TEAL TWADDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5816 OSAGE BEACH PKWY STE 107, OSAGE BEACH, MO 65065-3065
(573) 693-9017
Mailing address
5816 OSAGE BEACH PKWY STE 107, OSAGE BEACH, MO 65065-3065
(660) 853-1005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2015020717
MO
1223G0001X
General Practice Dentistry
2015020717
MO
Other
Enumeration date
07/23/2015
Last updated
08/04/2020
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