Individual
DR. PETER L. GLASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13270 HIGHWAY 90, BOUTTE, LA 70039
(985) 785-0123
(985) 785-0125
Mailing address
PO BOX 515, BOUTTE, LA 70039-0515
(985) 785-0123
(985) 785-0125
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1838
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
612049
UNITED CONCORDIA
LA
01
—
A1244
BLUE CROSS
LA
Enumeration date
01/10/2007
Last updated
07/08/2007
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