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General NPI Number Information
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NPI Number | 1487070850
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Entity Type | Organization
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Legal Business Name | BRIAN S. GLAZIER, DDS, P.C.
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 1760 N MAIN ST SUITE 106
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City | CEDAR CITY
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State | UT
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Zip | 84721-7775
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Country | US
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Telephone | 435-867-0644
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Fax | 435-867-0645
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Provider Business Mailing Address
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Address Line | 1760 N MAIN ST SUITE 106
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City | CEDAR CITY
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State | UT
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Zip | 84721-7775
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Country | US
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Telephone | 435-867-0644
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Fax | 435-867-0645
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN S GLAZIER
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Credential | DDS
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Telephone | 435-867-0644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 8807255-0144
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License Number State | UT
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