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General NPI Number Information
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NPI Number | 1447442637
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Entity Type | Organization
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Legal Business Name | MATTHEW W GLASGOW DDS PC
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 220 PROGRESS ST NE
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City | BLACKSBURG
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State | VA
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Zip | 24060-7320
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Country | US
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Telephone | 540-552-3111
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Fax | 540-381-9599
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Provider Business Mailing Address
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Address Line | 220 PROGRESS ST NE
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City | BLACKSBURG
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State | VA
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Zip | 24060-7320
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Country | US
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Telephone | 540-552-3111
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Fax | 540-381-9599
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. MATTHEW WILLIS GLASGOW
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Credential | DDS
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Telephone | 540-552-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401007032
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License Number State | VA
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