MEDICARE: HOWARD S GLAZER DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10749	NJ

General Provider Information

NPI Number	:	1639198682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOWARD S GLAZER DDS PA

Provider Business Mailing Address
First Line	:	810 ABBOTT BLVD
Second Line	:	SUITE 302
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4151
Country	:	US
Telephone Number	:	201-224-2705
Fax Number	:	201-224-7622

Provider Business Practice Location Address
First Line	:	810 ABBOTT BLVD
Second Line	:	SUITE 302
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4151
Country	:	US
Telephone Number	:	201-224-2705
Fax Number	:	201-224-7622

Authorized Official
Title or Position	:	PRES/CEO
Name	:	DR. HOWARD STEVEN GLAZER
Credential	:	DDS
Telephone Number	:	201-224-2705

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/22/2020

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