Individual
DR. GLENN GEORGE THOMASON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
U.S. HWY 84 N, CR 324, #14, TIERRA AMARILLA, NM 87576
(505) 588-7289
Mailing address
PO BOX 616, CHAMA, NM 87520-0616
(505) 756-2345
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD-2075
NM
Other
Enumeration date
11/23/2005
Last updated
07/08/2007
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