Provider Demographics
NPI:1356381057
Name:GLASER, LAWRENCE E (DMD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:E
Last Name:GLASER
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 1:1110 S CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7901
Mailing Address - Country:US
Mailing Address - Phone:610-433-2046
Mailing Address - Fax:610-433-2047
Practice Address - Street 1:1110 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7901
Practice Address - Country:US
Practice Address - Phone:610-433-2046
Practice Address - Fax:610-433-2047
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025539L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice