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General NPI Number Information
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NPI Number | 1619096252
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Entity Type | Individual
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Provider Name | ALEX MICHAEL GLUHAREFF D.D.S.,M.A.G.D.,P.A.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 11223 N WILLIAMS ST STE C
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City | DUNNELLON
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State | FL
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Zip | 34432
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Country | US
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Telephone | 352-489-3922
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Fax | 352-489-8462
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Provider Business Mailing Address
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Address Line | 11223 N WILLIAMS ST STE C
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City | DUNNELLON
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State | FL
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Zip | 34432
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Country | US
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Telephone | 352-489-3922
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Fax | 352-489-8462
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0010913
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License Number State | FL
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