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NPI Code Detail

MEDICARE: CLEMENT & TEEL PS CORPORATION

MEDICARE: CLEMENT & TEEL PS CORPORATION
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
11223G0001XGeneral Practice DentistryDE00006440WA

General Provider Information

NPI Number : 1639395122
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEMENT & TEEL PS CORPORATION
Provider Business Mailing Address
First Line : 3340 NE 125TH ST
Second Line : SUITE 2
City : SEATTLE
State : WA
Zip : 98125-8911
Country : US
Telephone Number : 206-363-6696
Fax Number : 206-363-0072
Provider Business Practice Location Address
First Line : 3340 NE 125TH ST
Second Line : SUITE 2
City : SEATTLE
State : WA
Zip : 98125-8911
Country : US
Telephone Number : 206-363-6696
Fax Number : 206-363-0072
Authorized Official
Title or Position : DENTIST
Name : DR. NANCY J TEEL
Credential : DDS
Telephone Number : 206-363-6696
Provider Enumeration Date : 04/17/2007
Last Update Date : 08/22/2020

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Directions to “CLEMENT & TEEL PS CORPORATION ” Practice Location

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