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Individual

DR. GLENN ROBERT HEAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
6 POINTE CIR, GREENVILLE, SC 29615-3506
(864) 233-1234
(864) 298-8009
Mailing address
6 POINTE CIR, GREENVILLE, SC 29615-3506
(864) 233-1234
(864) 298-8009

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2868
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZA9481
SC
Enumeration date
09/23/2005
Last updated
10/23/2012
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