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General NPI Number Information
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NPI Number | 1376686980
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Entity Type | Organization
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Legal Business Name | PAUL L GLICK, DDS, MS
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 26 W DRY CREEK CIRCLE STE 300
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City | LITTLETON
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State | CO
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Zip | 80120-8035
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Country | US
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Telephone | 303-795-5700
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Fax | 303-795-0134
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Provider Business Mailing Address
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Address Line | 26 W DRY CREEK CIRCLE STE 300
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City | LITTLETON
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State | CO
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Zip | 80120
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Country | US
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Telephone | 303-795-5700
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Fax | 303-795-0134
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL L GLICK
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Credential | DDS, MS
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Telephone | 303-795-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 105211
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License Number State | CO
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