Individual
DR. GLENN W BICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
25261 PASEO DE VALENCIA, SUITE 2, LAGUNA WOODS, CA 92637-4966
(949) 951-7988
(949) 581-5227
Mailing address
21611 MIDCREST DR, LAKE FOREST, CA 92630-6584
(949) 400-6923
(949) 581-5227
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
27236
CA
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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