MEDICARE: TERESA LYNN NESTOR RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	DH070137	PA

General Provider Information

NPI Number	:	1245467182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA LYNN NESTOR RDH

Provider Business Mailing Address
First Line	:	140 N BEESON AVE
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-2937
Country	:	US
Telephone Number	:	724-439-1628
Fax Number	:	724-438-2274

Provider Business Practice Location Address
First Line	:	140 N BEESON AVE
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-2937
Country	:	US
Telephone Number	:	724-439-1628
Fax Number	:	724-438-2274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2009
Last Update Date	:	06/18/2009

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