Provider Demographics
NPI:1346259165
Name:PEOPLES-VERNIER, GLENDA G (DDS)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:G
Last Name:PEOPLES-VERNIER
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 1:4848 DOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2329
Mailing Address - Country:US
Mailing Address - Phone:248-706-7739
Mailing Address - Fax:586-779-0926
Practice Address - Street 1:22855 KELLY RD
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2057
Practice Address - Country:US
Practice Address - Phone:586-779-6777
Practice Address - Fax:586-779-0926
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI144541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1B00Q5OtherBCBS OF MA
MI818900OtherUNITED CONCORDIA
MID800328OtherBCBS OF MI