Individual
MYRIAM GLAVASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6309 4TH ST STE 100, LUBBOCK, TX 79416-4281
(806) 516-0090
(806) 516-0091
Mailing address
4450 121ST LN, LUBBOCK, TX 79424-1386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
32287
TX
1223G0001X
General Practice Dentistry
DN20161
FL
1223P0221X
Pediatric Dentistry
Primary
32287
TX
Other
Enumeration date
06/18/2013
Last updated
12/06/2021
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