Provider Demographics
NPI:1295973667
Name:DENTON, GLENN A (CRTT)
Entity type:Individual
Prefix:MR
First Name:GLENN
Middle Name:A
Last Name:DENTON
Suffix:
Gender:M
Credentials:CRTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1402
Mailing Address - Country:US
Mailing Address - Phone:732-742-4911
Mailing Address - Fax:
Practice Address - Street 1:25 CHASE AVE
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1402
Practice Address - Country:US
Practice Address - Phone:732-742-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA001170002278P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Function Technologist