Provider Demographics
NPI:1871632026
Name:GLASGOW, KARRIE MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:KARRIE
Middle Name:MARIE
Last Name:GLASGOW
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 1:3440 FEDERAL DR STE 240
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3523
Mailing Address - Country:US
Mailing Address - Phone:651-983-7279
Mailing Address - Fax:
Practice Address - Street 1:3440 FEDERAL DR STE 240
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3523
Practice Address - Country:US
Practice Address - Phone:651-994-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND122161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice