Organization
PORT ROAD DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MICHAEL GLINCHER (OFFICE ADMINISTRATOR)
(414) 351-6300
Entity
Organization
Contact information
Practice address
7725 N PORT WASHINGTON RD, GLENDALE, WI 53217-3130
(414) 202-5215
Mailing address
7725 N PORT WASHINGTON RD, GLENDALE, WI 53217-3130
(414) 351-6300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
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