Individual
GLENN A HARRISON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
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
01
—
059572
BCBS
VA
01
—
1350032
UMWA
—
Enumeration date
05/15/2006
Last updated
07/08/2007
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