Provider Demographics
NPI:1508880915
Name:GLICK, ARTHUR L (D D S)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:L
Last Name:GLICK
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 NEWTOWN RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5600
Mailing Address - Country:US
Mailing Address - Phone:757-499-3163
Mailing Address - Fax:757-490-5703
Practice Address - Street 1:533 NEWTOWN RD
Practice Address - Street 2:SUITE 117
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5600
Practice Address - Country:US
Practice Address - Phone:757-499-3163
Practice Address - Fax:757-490-5703
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010037301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice