Provider Demographics
NPI:1255427563
Name:APPLETON, GLENN EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:EUGENE
Last Name:APPLETON
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 1:7742 OFFICE PARK BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-8636
Mailing Address - Country:US
Mailing Address - Phone:225-201-1000
Mailing Address - Fax:225-201-1005
Practice Address - Street 1:7742 OFFICE PARK BLVD STE A1
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-8636
Practice Address - Country:US
Practice Address - Phone:225-201-1000
Practice Address - Fax:225-201-1005
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA4679122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist