Individual
DR. WILLIAM JAMES GLENOS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
22 SAINT JOHNS MEDICAL PK DR, ST AUGUSTINE, FL 32086-5299
(904) 797-6453
Mailing address
107 INLET DR, ST AUGUSTINE, FL 32080-3812
(904) 824-4886
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN8867
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0722634
—
FL
Enumeration date
08/01/2006
Last updated
07/08/2007
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