Provider Demographics
NPI:1760605240
Name:CHARLES E. GLOVER III, DDS,P.C.
Entity Type:Organization
Organization Name:CHARLES E. GLOVER III, DDS,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-422-8055
Mailing Address - Street 1:660 CHEROKEE ST NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8910
Mailing Address - Country:US
Mailing Address - Phone:770-422-8055
Mailing Address - Fax:770-422-9688
Practice Address - Street 1:660 CHEROKEE ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8910
Practice Address - Country:US
Practice Address - Phone:770-422-8055
Practice Address - Fax:770-422-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA73101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty