Individual
DR. GLENN A PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
13245 KESSLER RD, CAIRO, IL 62914-3101
(618) 734-4400
(618) 734-2884
Mailing address
13245 KESSLER RD, CAIRO, IL 62914-3101
(618) 734-4400
(618) 734-2884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019015694
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019015694
—
IL
Enumeration date
10/18/2005
Last updated
12/07/2009
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