Individual
DR. GLEN GOLEBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1290 PEOPLES PLAZA, NEWARK, DE 19702
(302) 836-3750
(302) 836-2693
Mailing address
1290 PEOPLES PLAZA, NEWARK, DE 19702
(302) 836-3750
(302) 836-2693
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
G10000965
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001030708
—
DE
05
—
0001030831
—
DE
Enumeration date
10/02/2006
Last updated
12/01/2011
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