# GLENN W. FORTNER DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRAL VIRGINIA DENTAL CARE PLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013428374
- **Legal business name:** CENTRAL VIRGINIA DENTAL CARE PLC
- **Authorized official:** GLENN FORTNER (DENTIST)
- **Authorized official phone:** (804) 241-9813

## Contact information

- **Practice address:** 3950 SPRINGFIELD RD, GLEN ALLEN, VA 23060-4119
- **Practice address phone:** (804) 346-4600
- **Mailing address:** 3950 SPRINGFIELD RD, GLEN ALLEN, VA 23060-4119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2017
- **Last updated:** 10/13/2017