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General NPI Number Information
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NPI Number | 1548337983
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Entity Type | Individual
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Provider Name | GLENDA MARIA JOSON DMD
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 1301 W ARROW HWY SUITE 120
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City | SAN DIMAS
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State | CA
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Zip | 91773-2330
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Country | US
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Telephone | 909-592-8338
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Fax |
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Provider Business Mailing Address
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Address Line | 897 SAN MARCUS LN
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City | DUARTE
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State | CA
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Zip | 91010-2319
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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 | 51944
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License Number State | CA
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