Individual
NATHAN CORY GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
215 S JEFFERSON ST, WINCHESTER, TN 37398-1739
(931) 967-1933
Mailing address
215 S JEFFERSON ST, WINCHESTER, TN 37398-1739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8984
TN
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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