Healthcare Provider Details

I. General information

NPI: 1942390299
Provider Name (Legal Business Name): MARTIN N GLASER DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7409 MIAMI LAKES DR
MIAMI LAKES FL
33014-6818
US

IV. Provider business mailing address

7409 MIAMI LAKES DR
MIAMI LAKES FL
33014-6818
US

V. Phone/Fax

Practice location:
  • Phone: 305-557-0440
  • Fax: 305-557-0441
Mailing address:
  • Phone: 305-557-0440
  • Fax: 305-557-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTIN NEAL GLASER
Title or Position: PRES
Credential: DMD
Phone: 305-557-0440