Individual
DR. GLENN P GODART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
110 BERGEN ST, NEWARK, NJ 07101-1709
(973) 972-4615
Mailing address
88 SHERWOOD RD, RIDGEWOOD, NJ 07450-1320
(201) 447-4894
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI01155300
NJ
Other
Enumeration date
05/08/2007
Last updated
08/29/2013
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