MEDICARE: DR. TERRY S. WEST DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5573	NC

General Provider Information

NPI Number	:	1578542379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY S. WEST DDS

Provider Business Mailing Address
First Line	:	788 S ROUTE 4
Second Line	:	APT 607
City	:	SINAJANA
State	:	GU
Zip	:	96910-3357
Country	:	US
Telephone Number	:	671-472-5018
Fax Number	:

Provider Business Practice Location Address
First Line	:	U.S. NAVAL HOSPITAL GUAM
Second Line	:	FARENHOLT STREET BUILDING K-1
City	:	AGANA HEIGHTS
State	:	GU
Zip	:	96919
Country	:	US
Telephone Number	:	671-339-8086
Fax Number	:	671-339-4169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/08/2007

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