Provider Demographics
NPI:1376686980
Name:PAUL L GLICK, DDS, MS
Entity Type:Organization
Organization Name:PAUL L GLICK, DDS, MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:303-795-5700
Mailing Address - Street 1:26 W DRY CREEK CIRCLE
Mailing Address - Street 2:STE 300
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120
Mailing Address - Country:US
Mailing Address - Phone:303-795-5700
Mailing Address - Fax:303-795-0134
Practice Address - Street 1:26 W DRY CREEK CIRCLE
Practice Address - Street 2:STE 300
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8035
Practice Address - Country:US
Practice Address - Phone:303-795-5700
Practice Address - Fax:303-795-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1052111223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty