Provider Demographics
NPI:1023192697
Name:GLASS, ROBERT G (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:GLASS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 NORTH TRIGG AVE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:39066
Mailing Address - Country:US
Mailing Address - Phone:615-452-2081
Mailing Address - Fax:615-452-1150
Practice Address - Street 1:131 NORTH TRIGG AVE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:39066
Practice Address - Country:US
Practice Address - Phone:615-452-2081
Practice Address - Fax:615-452-1150
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice