Provider Demographics
NPI:1437342458
Name:GLEDHILL, LANCE W (DDS)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:W
Last Name:GLEDHILL
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 1:7223 W CLEARWATER AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1758
Mailing Address - Country:US
Mailing Address - Phone:509-783-8822
Mailing Address - Fax:509-783-1983
Practice Address - Street 1:7223 W CLEARWATER AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1758
Practice Address - Country:US
Practice Address - Phone:509-783-8822
Practice Address - Fax:509-783-1983
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00011069122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist