Provider Demographics
NPI:1518192160
Name:GLUSKI, KENNETH STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:STEVEN
Last Name:GLUSKI
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 1:1025 25TH ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-4407
Mailing Address - Country:US
Mailing Address - Phone:409-765-9190
Mailing Address - Fax:409-766-1825
Practice Address - Street 1:1025 25TH ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-4407
Practice Address - Country:US
Practice Address - Phone:409-765-9190
Practice Address - Fax:409-766-1825
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice