Provider Demographics
NPI:1992761845
Name:TEAGUE, ERIN KRISTEN (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:KRISTEN
Last Name:TEAGUE
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 1:98 NORMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2934
Mailing Address - Country:US
Mailing Address - Phone:718-389-6666
Mailing Address - Fax:718-389-6111
Practice Address - Street 1:98 NORMAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2934
Practice Address - Country:US
Practice Address - Phone:718-389-6666
Practice Address - Fax:718-389-6111
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYO524141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice