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NPI Code Detail

MEDICARE: MR. TERRY ALAN TEDFORD DDS

MEDICARE:  MR. TERRY ALAN TEDFORD  DDS
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
1122300000XDentist05155CO

General Provider Information

NPI Number : 1740272293
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TERRY ALAN TEDFORD DDS
Provider Business Mailing Address
First Line : 7265 S UNIVERSITY BLVD
Second Line : STE J
City : CENTENNIAL
State : CO
Zip : 80122
Country : US
Telephone Number : 303-770-8278
Fax Number : 303-770-8279
Provider Business Practice Location Address
First Line : 7562 S UNIVERSITY BLVD
Second Line : STE J
City : CENTENNIAL
State : CO
Zip : 80122-3159
Country : US
Telephone Number : 303-770-8278
Fax Number : 303-770-8279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 07/08/2007

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Directions to “ MR. TERRY ALAN TEDFORD DDS” Practice Location

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