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General NPI Number Information
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NPI Number | 1609279090
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Entity Type | Organization
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Legal Business Name | WILLIAM GLOVER III DMD LLC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 1507 S HIAWASSEE RD STE 209
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City | ORLANDO
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State | FL
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Zip | 32835-5719
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Country | US
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Telephone | 407-522-5595
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Fax | 407-522-5598
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Provider Business Mailing Address
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Address Line | 1507 S HIAWASSEE RD STE 209
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City | ORLANDO
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State | FL
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Zip | 32835-5719
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Country | US
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Telephone | 407-522-5595
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Fax | 407-522-5598
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | WILLIAM GLOVER III
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Credential | DMD
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Telephone | 407-522-5595
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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 |
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License Number State |
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