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Individual

DR. LATISHA OPAL GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
131 COLUMBIA AVE E, BATTLE CREEK, MI 49015-3788
(269) 963-9670
(269) 963-9672
Mailing address
131 COLUMBIA AVE E, BATTLE CREEK, MI 49015-3788
(269) 963-9670
(269) 963-9672

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019115
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4766214
MI
Enumeration date
04/05/2006
Last updated
01/15/2015
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