Healthcare Provider Details

I. General information

NPI: 1285753855
Provider Name (Legal Business Name): BARRY H. GLASSMAN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 W HAMILTON ST
ALLENTOWN PA
18102-4328
US

IV. Provider business mailing address

1329 W HAMILTON ST
ALLENTOWN PA
18102-4328
US

V. Phone/Fax

Practice location:
  • Phone: 610-435-6724
  • Fax: 610-435-3482
Mailing address:
  • Phone: 610-435-6724
  • Fax: 610-435-3482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS018205
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: