Provider Demographics
NPI:1194114132
Name:TEAGUE & VAN PRAAG, DDS, PLLC
Entity type:Organization
Organization Name:TEAGUE & VAN PRAAG, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN PRAAG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-231-9427
Mailing Address - Street 1:418 JONES COVE RD
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-9458
Mailing Address - Country:US
Mailing Address - Phone:828-627-9285
Mailing Address - Fax:828-627-2964
Practice Address - Street 1:418 JONES COVE RD
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-9458
Practice Address - Country:US
Practice Address - Phone:828-627-9285
Practice Address - Fax:828-627-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty