MEDICARE: DR. HOWARD STEVEN GLAZER DDS

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	:	1952303000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD STEVEN GLAZER DDS

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

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

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/08/2007

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