Individual
DR. CODY JAY GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
237 W HICKORY ST, LANCASTER, WI 53813-1457
(608) 723-2141
Mailing address
524 N MADISON ST, LANCASTER, WI 53813-1130
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002610
WI
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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