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Individual

DR. RANDALL FRANCIS GLENN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
3043 S MERIDIAN RD STE 100, MERIDIAN, ID 83642-7936
(208) 884-0888
Mailing address
3043 S MERIDIAN RD STE 100, MERIDIAN, ID 83642-7936
(208) 884-0888

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4962
ID
1223G0001X
General Practice Dentistry
D8324
OR

Other

Enumeration date
07/07/2005
Last updated
02/10/2025
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