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Individual

DR. JASON P GLASSLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.D.

Contact information

Practice address
5718 COVENTRY LN, FORT WAYNE, IN 46804-7141
(260) 436-5772
(260) 436-5779
Mailing address
1801 GALAPAGOS CT, FORT WAYNE, IN 46814-8872
(260) 436-5772
(260) 436-5779

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12010736A
IN

Other

Enumeration date
06/29/2008
Last updated
06/29/2008
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