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1801904321
RUSSELL EUGENE GLENN
GRAND PRAIRIE, TX
NPI
1801904321
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: TX 16051)
Enumeration Date
2006-08-25
Last Update Date
2007-07-08
Business Address
Dr. RUSSELL EUGENE GLENN DDO
573 W PIONEER PKWY
GRAND PRAIRIE, TX 75051
Phone number: 972-642-5775
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Mailing Address
Dr. RUSSELL EUGENE GLENN DDO
573 W PIONEER PKWY
GRAND PRAIRIE, TX 75051
Phone number: 972-642-5775
Copy
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