Provider Demographics
NPI:1548954886
Name:BYRNES, TEAGAN MACKENNA (DDS)
Entity type:Individual
Prefix:DR
First Name:TEAGAN
Middle Name:MACKENNA
Last Name:BYRNES
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 1:8411 PEOSTA COMMERCIAL CT UNIT 303
Mailing Address - Street 2:
Mailing Address - City:PEOSTA
Mailing Address - State:IA
Mailing Address - Zip Code:52068-7102
Mailing Address - Country:US
Mailing Address - Phone:813-860-1335
Mailing Address - Fax:
Practice Address - Street 1:2055 HOLLIDAY DR STE 100
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-0415
Practice Address - Country:US
Practice Address - Phone:563-588-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-101071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice