Provider Demographics
NPI:1215044706
Name:GLADNICK, DANN JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANN
Middle Name:JAMES
Last Name:GLADNICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 N BROOM ST
Mailing Address - Street 2:2
Mailing Address - City:WILM
Mailing Address - State:DE
Mailing Address - Zip Code:19806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1104 N BROOM ST
Practice Address - Street 2:2
Practice Address - City:WILM
Practice Address - State:DE
Practice Address - Zip Code:19806
Practice Address - Country:US
Practice Address - Phone:302-654-7243
Practice Address - Fax:302-654-9907
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG10000964122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist