Individual
LACIE ELIZABETH WILSON GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3147 SW 45TH ST STE 40, GAINESVILLE, FL 32608-2399
(352) 389-4386
Mailing address
1201 MERCER ST UNIT 405, SEATTLE, WA 98109-5780
(352) 283-1535
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
24315
FL
Other
Enumeration date
12/28/2022
Last updated
12/28/2022
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