Provider Demographics
NPI:1265624654
Name:ARTHUR L. GLICK, D.D.S., P.C.
Entity type:Organization
Organization Name:ARTHUR L. GLICK, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-499-3163
Mailing Address - Street 1:533 NEWTOWN RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5600
Mailing Address - Country:US
Mailing Address - Phone:757-499-3163
Mailing Address - Fax:757-490-5703
Practice Address - Street 1:533 NEWTOWN RD
Practice Address - Street 2:SUITE 117
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5600
Practice Address - Country:US
Practice Address - Phone:757-499-3163
Practice Address - Fax:757-490-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401003730261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical