Individual
MR. GLENN JOSEPH GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
219 HAMPDEN AVE, NARBERTH, PA 19072-1909
(610) 668-8877
Mailing address
219 HAMPDEN AVE, NARBERTH, PA 19072-1909
(610) 668-8877
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN021671A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
816632
UNITED CONCORDIA
—
Enumeration date
10/24/2006
Last updated
07/08/2007
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