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General NPI Number Information
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NPI Number | 1689338121
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Entity Type | Organization
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Legal Business Name | GLICK & WOODS DENTISTRY PLLC
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 208 N WASHINGTON ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-3649
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Country | US
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Telephone | 931-455-3917
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Fax |
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Provider Business Mailing Address
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Address Line | 208 N WASHINGTON ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-3649
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Country | US
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Telephone | 931-455-3917
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | LOGAN SMITH
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Credential | DDS
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Telephone | 972-869-3789
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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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