MEDICARE: DR. MICHELLE TEOH D.D.S.

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	1223G0001X	General Practice Dentistry	23065	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23065	OTHER	TX	CHIP NUMBER

General Provider Information

NPI Number	:	1609097401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE TEOH D.D.S.

Provider Business Mailing Address
First Line	:	1420 W MOCKINGBIRD LN
Second Line	:	SUITE 500
City	:	DALLAS
State	:	TX
Zip	:	75247-4931
Country	:	US
Telephone Number	:	214-630-7080
Fax Number	:	214-630-7085

Provider Business Practice Location Address
First Line	:	1420 W MOCKINGBIRD LN
Second Line	:	SUITE 500
City	:	DALLAS
State	:	TX
Zip	:	75247-4931
Country	:	US
Telephone Number	:	214-630-7080
Fax Number	:	214-630-7085

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/09/2007

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Directions to “ DR. MICHELLE TEOH D.D.S.” Practice Location

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