Provider Demographics
NPI:1669639464
Name:NGAN, GLENN HO (DDS)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:HO
Last Name:NGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:19 BOWERY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6702
Mailing Address - Country:US
Mailing Address - Phone:212-431-4306
Mailing Address - Fax:212-625-8922
Practice Address - Street 1:19 BOWERY
Practice Address - Street 2:SUITE 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6702
Practice Address - Country:US
Practice Address - Phone:212-431-4306
Practice Address - Fax:212-625-8922
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0469021223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics