Provider Demographics
NPI:1275186611
Name:TERLAJE, RAYNER D (DDS,MS)
Entity Type:Individual
Prefix:MR
First Name:RAYNER
Middle Name:D
Last Name:TERLAJE
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:250 ROUTE 4 STE 101
Mailing Address - Street 2:
Mailing Address - City:HAGATNA
Mailing Address - State:GU
Mailing Address - Zip Code:96910-7110
Mailing Address - Country:US
Mailing Address - Phone:671-646-7982
Mailing Address - Fax:671-646-7989
Practice Address - Street 1:250 ROUTE 4 STE 101
Practice Address - Street 2:
Practice Address - City:HAGATNA
Practice Address - State:GU
Practice Address - Zip Code:96910-7110
Practice Address - Country:US
Practice Address - Phone:671-646-7982
Practice Address - Fax:671-646-7989
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUD9011223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry