Individual
DR. GLENN STEPHEN ROEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
230 N MARYLAND AVE, GLENDALE, CA 91206-4261
(310) 739-5579
Mailing address
PO BOX 67827, LOS ANGELES, CA 90067-2806
(310) 739-5579
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
30624
CA
Other
Enumeration date
01/11/2007
Last updated
04/01/2009
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