Provider Demographics
NPI:1346201993
Name:GLAZER, SHERI BETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:BETH
Last Name:GLAZER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 TERRACE CIR
Mailing Address - Street 2:APT. 4A
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4174
Mailing Address - Country:US
Mailing Address - Phone:516-504-0043
Mailing Address - Fax:
Practice Address - Street 1:260 MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2982
Practice Address - Country:US
Practice Address - Phone:631-361-3666
Practice Address - Fax:631-361-4823
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048924-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice