Provider Demographics
NPI:1669579967
Name:GLASER, CARL GERHARDT (DMD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:GERHARDT
Last Name:GLASER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:646 SWIFT RD
Mailing Address - Street 2:UNITED STATES MILITARY ACADEMY DENTAC,
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996-1905
Mailing Address - Country:US
Mailing Address - Phone:845-938-4212
Mailing Address - Fax:845-938-4302
Practice Address - Street 1:US ARMY DENTAL ACTIVITY
Practice Address - Street 2:DENTAC, BLDG 606, 1ST FLOOR
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1905
Practice Address - Country:US
Practice Address - Phone:845-938-4212
Practice Address - Fax:845-938-4302
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ22D1010961001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice