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General NPI Number Information
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NPI Number | 1336586965
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Entity Type | Individual
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Provider Name | DR. NATHAN GLASGOW
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Gender | Male
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 40B GROVE ST # B
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City | PITTSFORD
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State | NY
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Zip | 14534-1317
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Country | US
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Telephone | 585-586-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 860 HIGH ST
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City | VICTOR
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State | NY
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Zip | 14564-1172
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 057369
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License Number State | NY
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