Provider Demographics
NPI:1376789057
Name:STEPHEN D GLASS DDS PLLC
Entity Type:Organization
Organization Name:STEPHEN D GLASS DDS PLLC
Other - Org Name:ADVANCED DENTISTRY OF SPRING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-376-1214
Mailing Address - Street 1:7000 LOUETTA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7456
Mailing Address - Country:US
Mailing Address - Phone:281-376-1214
Mailing Address - Fax:281-257-2704
Practice Address - Street 1:7000 LOUETTA RD
Practice Address - Street 2:SUITE A
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7456
Practice Address - Country:US
Practice Address - Phone:281-376-1214
Practice Address - Fax:281-257-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
TX19852261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty