Organization
IAN ANDREW GLASER DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IAN ANDREW GLASER DDS (PRESIDENT)
(631) 724-1200
Entity
Organization
Contact information
Practice address
30 LANDING AVENUE, SMITHTOWN, NY 11787-2711
(631) 724-1200
(631) 724-1201
Mailing address
30 LANDING AVENUE, SMITHTOWN, NY 11787-2711
(631) 724-1200
(631) 724-1201
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
036700
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00908801
—
NY
Enumeration date
05/03/2007
Last updated
03/18/2010
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