Provider Demographics
NPI:1881826469
Name:GLOTZER, DAVID LEONARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEONARD
Last Name:GLOTZER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 ROOSEVELT WAY
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6687
Mailing Address - Country:US
Mailing Address - Phone:212-998-9625
Mailing Address - Fax:
Practice Address - Street 1:1139 ROOSEVELT WAY
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6687
Practice Address - Country:US
Practice Address - Phone:212-998-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice