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Individual
GLENDON W SMALLEY III
Active
Individual
GLENDON W SMALLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN014148
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN014148
GA
Other
Enumeration date
04/21/2010
Last updated
10/18/2019
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