Provider Demographics
NPI:1902001019
Name:VO, GLENN LEON (DDS)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:LEON
Last Name:VO
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 1:721 I-35E SOUTH STE.206
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205
Mailing Address - Country:US
Mailing Address - Phone:940-380-1188
Mailing Address - Fax:940-380-1199
Practice Address - Street 1:721 I-35E SOUTH STE.206
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205
Practice Address - Country:US
Practice Address - Phone:940-380-1188
Practice Address - Fax:940-380-1199
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23273122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist