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General NPI Number Information
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NPI Number | 1992851463
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Entity Type | Individual
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Provider Name | CAROL A. TEREBA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2900 ELM RD NE
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City | WARREN
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State | OH
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Zip | 44483-2606
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Country | US
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Telephone | 330-372-1236
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Fax |
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Provider Business Mailing Address
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Address Line | 230 FOX RUN
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City | CORTLAND
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State | OH
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Zip | 44410-1171
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Country | US
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Telephone | 330-637-7670
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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 | 20338
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License Number State | OH
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