Provider Demographics
NPI:1376595165
Name:BARLOW, GLEN R (DDS)
Entity Type:Individual
Prefix:
First Name:GLEN
Middle Name:R
Last Name:BARLOW
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 1:842 DURHAM ROAD
Mailing Address - Street 2:STE 25
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-9683
Mailing Address - Country:US
Mailing Address - Phone:215-598-0800
Mailing Address - Fax:215-598-8971
Practice Address - Street 1:842 DURHAM ROAD
Practice Address - Street 2:STE 25
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9683
Practice Address - Country:US
Practice Address - Phone:215-598-0800
Practice Address - Fax:215-598-8971
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023715L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist