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General NPI Number Information
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NPI Number | 1780753293
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Entity Type | Organization
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Legal Business Name | C. FRED GLAZENER, D.D.S., INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 2681 STATE HIGHWAY 361
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City | INGLESIDE
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State | TX
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Zip | 78362-4200
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Country | US
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Telephone | 361-776-3535
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Fax | 866-766-2629
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Provider Business Mailing Address
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Address Line | 2681 STATE HIGHWAY 361
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City | INGLESIDE
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State | TX
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Zip | 78362-4200
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Country | US
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Telephone | 361-776-3535
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Fax | 866-766-2629
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. C FRED GLAZENER
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Credential | DDS
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Telephone | 361-776-3535
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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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