Provider Demographics
NPI:1265531057
Name:JOEL F GLOVER DDS LTD
Entity type:Organization
Organization Name:JOEL F GLOVER DDS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-825-2227
Mailing Address - Street 1:525 HAMMILL LANE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1004
Mailing Address - Country:US
Mailing Address - Phone:775-825-2227
Mailing Address - Fax:775-825-5936
Practice Address - Street 1:525 HAMMILL LANE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1004
Practice Address - Country:US
Practice Address - Phone:775-825-2227
Practice Address - Fax:775-825-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV31861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002216741Medicaid
NV002216804Medicaid