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DR. GLEN ALLEN EISENHUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8885
Mailing address
PO BOX 1785, FORT DEFIANCE, AZ 86504-1785
(928) 729-8000

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D008343
AZ
1223E0200X
Endodontics
D10716
MN
1223E0200X
Endodontics
DD2828
NM

Other

Enumeration date
11/01/2006
Last updated
12/19/2025
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