Provider Demographics
NPI:1750630265
Name:GLAZER, BRITTANEY LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRITTANEY
Middle Name:LEE
Last Name:GLAZER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 N TOWN EAST BLVD
Mailing Address - Street 2:#111
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4172
Mailing Address - Country:US
Mailing Address - Phone:972-270-7210
Mailing Address - Fax:
Practice Address - Street 1:1765 N TOWN EAST BLVD
Practice Address - Street 2:#111
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4172
Practice Address - Country:US
Practice Address - Phone:972-270-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX282981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice