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General NPI Number Information
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NPI Number | 1659448108
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Entity Type | Individual
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Provider Name | JAYSON J TERRES DDS, MD, FACS, FAACS
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 805 TURTLE CREEK DR
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City | TYLER
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State | TX
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Zip | 75701-1937
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Country | US
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Telephone | 903-592-1664
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Fax | 903-525-1099
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Provider Business Mailing Address
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Address Line | 805 TURTLE CREEK DR
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City | TYLER
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State | TX
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Zip | 75701-1937
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Country | US
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Telephone | 903-592-1664
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Fax | 903-592-6595
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22097
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | M4965
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | M4965
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License Number State | TX
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