| NPI | 1740973429 |
|---|---|
| Doing Business As | GLEN PERIO AND IMPLANT DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JEANETTE FRUHMAN Controller 516-312-4735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-05-30 |