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Organization

EUGENE H. GLAD D.M.D. P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EUGENE HARRISON GLAD D.M.D. (ORTHODONTIST)
(207) 622-1430
Entity
Organization

Contact information

Practice address
11 MIDDLE ST, SUITE 1, AUGUSTA, ME 04330-5210
(207) 622-1430
Mailing address
11 MIDDLE ST, SUITE 1, AUGUSTA, ME 04330-5210
(207) 622-1430

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN2870
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123710000
ME
Enumeration date
11/30/2009
Last updated
11/30/2009
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