Individual
DR. DUDLEY BREWER GLASS, JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1002 LEXINGTON RD, STE. 20, GEORGETOWN, KY 40324-1463
(502) 863-5442
Mailing address
2855 LONG LICK PIKE, GEORGETOWN, KY 40324-9462
(502) 535-7762
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4494
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4494
STATE LICENSE NUMBER
KY
Enumeration date
07/31/2006
Last updated
07/08/2007
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