Provider Demographics
NPI:1467598763
Name:GLOVER, EDWARD AUGUSTUS IV (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:AUGUSTUS
Last Name:GLOVER
Suffix:IV
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3900 JOE RAMSEY BLVD E
Mailing Address - Street 2:STE. 2A
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7727
Mailing Address - Country:US
Mailing Address - Phone:903-455-7673
Mailing Address - Fax:903-455-5534
Practice Address - Street 1:3900 JOE RAMSEY BLVD E
Practice Address - Street 2:STE. 2A
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7727
Practice Address - Country:US
Practice Address - Phone:903-455-7673
Practice Address - Fax:903-455-5534
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX118981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice