Provider Demographics
NPI:1174746549
Name:BAISEY, TERESA A (DDS)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:A
Last Name:BAISEY
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 1:9743 S CONGRESS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW MARKET
Mailing Address - State:VA
Mailing Address - Zip Code:22844-9611
Mailing Address - Country:US
Mailing Address - Phone:540-740-3660
Mailing Address - Fax:
Practice Address - Street 1:9743 S CONGRESS ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW MARKET
Practice Address - State:VA
Practice Address - Zip Code:22844-9611
Practice Address - Country:US
Practice Address - Phone:540-740-3660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist