Provider Demographics
NPI:1295875219
Name:HARPER, GLENWOOD BARTHOLOMEW (DMD)
Entity type:Individual
Prefix:DR
First Name:GLENWOOD
Middle Name:BARTHOLOMEW
Last Name:HARPER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 SCOTLAND RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-2209
Mailing Address - Country:US
Mailing Address - Phone:973-672-2276
Mailing Address - Fax:973-674-8482
Practice Address - Street 1:514 SCOTLAND RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-2209
Practice Address - Country:US
Practice Address - Phone:973-672-2276
Practice Address - Fax:973-674-8482
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ113081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice