Provider Demographics
NPI:1639198682
Name:HOWARD S GLAZER DDS PA
Entity Type:Organization
Organization Name:HOWARD S GLAZER DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GLAZER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-224-2705
Mailing Address - Street 1:810 ABBOTT BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4151
Mailing Address - Country:US
Mailing Address - Phone:201-224-2705
Mailing Address - Fax:201-224-7622
Practice Address - Street 1:810 ABBOTT BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4151
Practice Address - Country:US
Practice Address - Phone:201-224-2705
Practice Address - Fax:201-224-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ107491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty