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NPI Code Detail

MEDICARE: DR. GARY L. GLASBAND D.D.S.

MEDICARE:  DR. GARY L. GLASBAND  D.D.S.
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
1122300000XDentist33460CA

General Provider Information

NPI Number : 1962622340
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY L. GLASBAND D.D.S.
Provider Business Mailing Address
First Line : 6226 E. SPRING ST. #350
Second Line :
City : LONG BEACH
State : CA
Zip : 90815
Country : US
Telephone Number : 562-425-5511
Fax Number : 562-425-9685
Provider Business Practice Location Address
First Line : 6226 E SPRING ST STE 350
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-1447
Country : US
Telephone Number : 562-425-5511
Fax Number : 562-425-9685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 07/08/2007

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