Provider Demographics
NPI:1477743433
Name:GLASSMAN, KARL JAY (DDS)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:JAY
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 GLENLIVET DR
Mailing Address - Street 2:SUITE C-38
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-3112
Mailing Address - Country:US
Mailing Address - Phone:610-395-0980
Mailing Address - Fax:484-223-1933
Practice Address - Street 1:1150 GLENLIVET DR
Practice Address - Street 2:SUITE C-38
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-3112
Practice Address - Country:US
Practice Address - Phone:610-395-0980
Practice Address - Fax:484-223-1933
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS016411L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1780745471OtherNPI