Individual
DR. GLEN DAVID MAYLATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
50 W BIG BEAVER RD STE 120, BLOOMFIELD HILLS, MI 48304-3911
(248) 642-5020
Mailing address
50 W BIG BEAVER RD STE 120, BLOOMFIELD HILLS, MI 48304-3911
(248) 642-5020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014767
MI
Other
Enumeration date
10/27/2006
Last updated
12/04/2013
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