Individual
DR. RICHARD J. GLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
14625 CALIFORNIA ST, OMAHA, NE 68154-1950
(402) 397-7777
(402) 390-9336
Mailing address
14625 CALIFORNIA ST, OMAHA, NE 68154-1950
(402) 397-7777
(402) 390-9336
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6279
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025375700
—
NE
01
—
5743
BCBS OF NE
NE
01
—
P0036733
MEDICARE RAILROAD
—
Enumeration date
05/16/2006
Last updated
01/31/2008
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