# A.E. UNDERWOOD DDSTODD GLAZENER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568590271
- **Authorized official:** DR. A E UNDERWOOD (DENTIST)
- **Authorized official phone:** (336) 774-0520

## Contact information

- **Practice address:** 3465 POLO RD, WINSTON SALEM, NC 27106
- **Practice address phone:** (336) 774-0520
- **Mailing address:** 3465 POLO RD, WINSTON SALEM, CA 27106
- **Mailing address phone:** (336) 774-0520

## Taxonomy

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

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 08/22/2020