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1730242140
GLEN W HISEL
CLOVIS, NM
NPI
1730242140
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NM 1748)
Enumeration Date
2006-12-18
Last Update Date
2007-07-08
Business Address
Dr. GLEN W HISEL D.D.S.
221 FAIRWAY TER N
CLOVIS, NM 88101-3064
Phone number: 505-762-3711
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Mailing Address
Dr. GLEN W HISEL D.D.S.
221 FAIRWAY TER N
CLOVIS, NM 88101-3064
Phone number: 505-762-3711
Copy
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