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General NPI Number Information
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NPI Number | 1548954886
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Entity Type | Individual
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Provider Name | TEAGAN MACKENNA BYRNES DDS
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Gender | Female
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 2055 HOLLIDAY DR STE 100
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City | DUBUQUE
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State | IA
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Zip | 52002-0415
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Country | US
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Telephone | 563-588-2585
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Fax |
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Provider Business Mailing Address
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Address Line | 8411 PEOSTA COMMERCIAL CT UNIT 303
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City | PEOSTA
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State | IA
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Zip | 52068-7102
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Country | US
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Telephone | 813-860-1335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS-10107
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License Number State | IA
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