Individual
MICHAEL GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6971 EL CAMINO REAL, CARLSBAD, CA 92009-4114
(760) 688-0791
Mailing address
4499 OHIO ST APT 251, SAN DIEGO, CA 92116-4596
(913) 486-2627
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DDS112542
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2021
Last updated
04/08/2026
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