Provider Demographics
NPI:1699084426
Name:TERKOSKI, MARY (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:TERKOSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 KEARNEY SQ
Mailing Address - Street 2:DENTAL HYGIENE PROGRAM -- TALBOT BLDG. 5TH FLOOR
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1901
Mailing Address - Country:US
Mailing Address - Phone:978-656-3059
Mailing Address - Fax:
Practice Address - Street 1:44 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1813
Practice Address - Country:US
Practice Address - Phone:978-656-3059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN17324122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist