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General NPI Number Information
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NPI Number | 1780970657
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE TERSTRIEP D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 330 VERMONT ST
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City | QUINCY
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State | IL
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Zip | 62301-2700
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Country | US
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Telephone | 217-222-8440
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Fax | 217-222-8508
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Provider Business Mailing Address
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Address Line | PO BOX 19639
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City | SPRINGFIELD
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State | IL
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Zip | 62794-9639
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Country | US
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Telephone | 217-545-8000
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Fax | 844-470-2486
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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 | 019.028746
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License Number State | IL
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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 | 2011022775
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License Number State | MO
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