Healthcare Provider Details

I. General information

NPI: 1447375316
Provider Name (Legal Business Name): TERESA ESKER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BALD RIDGE MARINA RD SUITE 200
CUMMING GA
30041-8494
US

IV. Provider business mailing address

PO BOX 599
CUMMING GA
30028-0599
US

V. Phone/Fax

Practice location:
  • Phone: 770-781-8650
  • Fax: 770-781-2953
Mailing address:
  • Phone: 770-781-8650
  • Fax: 770-781-2953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN012306
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: