Provider Demographics
NPI:1093873861
Name:ZEH, GLENN A (DDS)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:A
Last Name:ZEH
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 1:238 E BURTON LN
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-2826
Mailing Address - Country:US
Mailing Address - Phone:801-444-7074
Mailing Address - Fax:
Practice Address - Street 1:1147 ROSEWOOD LN
Practice Address - Street 2:STE 1
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5102
Practice Address - Country:US
Practice Address - Phone:801-544-2256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT337500-99231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice