Organization
GLENN A. HARRISON, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN A. HARRISON D.D.S. (PRESIDENT)
(276) 964-9109
Entity
Organization
Contact information
Practice address
2951 WEST FRONT STREET, SUITE 3800, RICHLANDS, VA 24641
(276) 964-9109
(276) 963-7205
Mailing address
2951 WEST FRONT STREET, SUITE 3800, RICHLANDS, VA 24641
(276) 964-9109
(276) 963-7205
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6836
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008000026
—
VA
Enumeration date
02/08/2010
Last updated
02/04/2011
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