Individual
DR. RONALD GERALD GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
152 COONROD AVENUE, MANNFORD, OK 74044
(918) 865-2247
Mailing address
PO BOX 945, MANNFORD, OK 74044-0945
(918) 865-2247
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4873
OK
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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