Provider Demographics
NPI:1922267095
Name:GLASNER, LARRY THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:THOMAS
Last Name:GLASNER
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 1:103 CAMELOT DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-9037
Mailing Address - Country:US
Mailing Address - Phone:828-437-9976
Mailing Address - Fax:
Practice Address - Street 1:5155 WESTERN AVE
Practice Address - Street 2:PO DRAWER 1439
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-9696
Practice Address - Country:US
Practice Address - Phone:828-438-6037
Practice Address - Fax:828-439-2312
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist