Provider Demographics
NPI:1659492668
Name:GLORE, JAMES WINFIELD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WINFIELD
Last Name:GLORE
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1801 W WISCONSIN AVE
Mailing Address - Street 2:MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-2186
Mailing Address - Country:US
Mailing Address - Phone:414-288-7155
Mailing Address - Fax:414-288-7870
Practice Address - Street 1:1801 W WISCONSIN AVE
Practice Address - Street 2:MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2186
Practice Address - Country:US
Practice Address - Phone:414-288-7155
Practice Address - Fax:414-288-7870
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
WI54-8751223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery