| NPI | 1063684827 |
|---|---|
| Professional Name | BERNARD RAYMOND TELLEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 11373) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 11373) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |