Provider Demographics
NPI:1922328095
Name:GLAZMAN, IRINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:
Last Name:GLAZMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 RIMMON HILL RD
Mailing Address - Street 2:
Mailing Address - City:BEACON FALLS
Mailing Address - State:CT
Mailing Address - Zip Code:06403-1554
Mailing Address - Country:US
Mailing Address - Phone:203-232-6787
Mailing Address - Fax:
Practice Address - Street 1:836 FARMINGTON AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1505
Practice Address - Country:US
Practice Address - Phone:860-231-8077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009597122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist