Individual
DR. GLENN DAVID GERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2573 CHAIN BRIDGE RD, VIENNA, VA 22181-5576
(703) 281-0041
(703) 281-0088
Mailing address
11420 MEADOW LAKE CT, OAKTON, VA 22124-1157
(703) 264-0924
(703) 264-0479
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401006015
VA
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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