Individual
GLEN HACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 ELIOT PL, FAIRFIELD, CT 06824-5154
(203) 259-5067
Mailing address
1 ELIOT PL, FAIRFIELD, CT 06824-5154
(203) 259-5067
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
007148
CT
Other
Enumeration date
11/22/2006
Last updated
07/08/2007
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