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General NPI Number Information
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NPI Number | 1659943371
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Entity Type | Individual
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Provider Name | RYAN M TEAGARDIN DMD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 6376 SAN MATEO DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911-4015
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Country | US
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Telephone | 815-262-4840
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Fax |
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Provider Business Mailing Address
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Address Line | 1667 COCHRANE CIR BLDG 7495
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City | FORT CARSON
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State | CO
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Zip | 80913-4603
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Country | US
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Telephone | 719-526-5537
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 12341536-9921
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00205916
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License Number State | CO
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