Provider Demographics
NPI:1346722725
Name:GLOVER, GATLIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:GATLIN
Middle Name:
Last Name:GLOVER
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 1:1412 SHARPSBURG CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1737
Mailing Address - Country:US
Mailing Address - Phone:662-820-0811
Mailing Address - Fax:
Practice Address - Street 1:230 E 10TH ST STE 106
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5771
Practice Address - Country:US
Practice Address - Phone:256-741-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist