Provider Demographics
NPI:1689839284
Name:GLASSMAN, RICK C (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:C
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:FREDRIC
Other - Middle Name:CHARLES
Other - Last Name:GLASSMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:9 MAVERICK LN
Mailing Address - Street 2:
Mailing Address - City:BELL CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1028
Mailing Address - Country:US
Mailing Address - Phone:818-575-8040
Mailing Address - Fax:818-887-0515
Practice Address - Street 1:2 DOLE DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-7300
Practice Address - Country:US
Practice Address - Phone:818-575-8040
Practice Address - Fax:818-887-0515
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist