Provider Demographics
NPI:1902000219
Name:THOMAS W. GLASS DDS, PA
Entity Type:Organization
Organization Name:THOMAS W. GLASS DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-948-2728
Mailing Address - Street 1:201 BROOKES AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2901
Mailing Address - Country:US
Mailing Address - Phone:301-948-2728
Mailing Address - Fax:301-948-2727
Practice Address - Street 1:201 BROOKES AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2901
Practice Address - Country:US
Practice Address - Phone:301-948-2728
Practice Address - Fax:301-948-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD069481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty