Individual
GLEN JOSEPH MARSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
998 CRESCENT LAKE RD, WATERFORD, MI 48327-2594
(248) 682-9331
(248) 682-9926
Mailing address
998 CRESCENT LAKE RD, WATERFORD, MI 48327-2594
(248) 682-9331
(248) 682-9266
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12583
MI
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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