Individual
DR. GLEN W FISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
55981 E COLFAX AVE, STRASBURG, CO 80136-8014
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5147
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-014225
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12978345
—
CO
Enumeration date
03/31/2006
Last updated
04/03/2017
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