Provider Demographics
NPI:1790812618
Name:JARNAGIN, TERI K (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:K
Last Name:JARNAGIN
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 1:13012 OLD GLENN HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7561
Mailing Address - Country:US
Mailing Address - Phone:907-694-2129
Mailing Address - Fax:907-694-1129
Practice Address - Street 1:13012 OLD GLENN HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7561
Practice Address - Country:US
Practice Address - Phone:907-694-2129
Practice Address - Fax:907-694-1129
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice