Provider Demographics
NPI:1205626637
Name:GLASGOW DENTAL CLINIC, LLC
Entity type:Organization
Organization Name:GLASGOW DENTAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOLYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:REYLINGCAPDEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:816-617-2471
Mailing Address - Street 1:PO BOX 809
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:MT
Mailing Address - Zip Code:59230-0809
Mailing Address - Country:US
Mailing Address - Phone:406-288-2656
Mailing Address - Fax:406-228-2656
Practice Address - Street 1:1009 6TH AVE N
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:MT
Practice Address - Zip Code:59230-1659
Practice Address - Country:US
Practice Address - Phone:406-288-2656
Practice Address - Fax:406-228-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental