Individual
DR. ELLIOTT DANIEL GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10401 W LINCOLN AVE, MILWAUKEE, WI 53227-1255
(414) 546-1900
(414) 546-1901
Mailing address
10401 W LINCOLN AVE, MILWAUKEE, WI 53227-1255
(414) 546-1900
(414) 546-1901
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
100226515
WI
1223E0200X
Endodontics
DDS-09873
IA
390200000X
Student in an Organized Health Care Education/Training Program
RES-30529
IA
Other
Enumeration date
06/12/2018
Last updated
08/25/2021
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