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General NPI Number Information
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NPI Number | 1558398255
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Entity Type | Individual
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Provider Name | GLENN R FOREMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8147 E EVANS RD SUITE 1
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3646
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Country | US
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Telephone | 480-443-3552
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Fax | 480-443-8810
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Provider Business Mailing Address
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Address Line | 8147 E EVANS RD SUITE 1
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3646
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Country | US
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Telephone | 480-443-3552
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Fax | 480-443-8810
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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 | D1887
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License Number State | AZ
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