Provider Demographics
NPI:1962999342
Name:GLOVER, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GLOVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY DENTAL HEALTH ACTIVITY
Mailing Address - Street 2:
Mailing Address - City:FORT STEWART
Mailing Address - State:NY
Mailing Address - Zip Code:31314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:US ARMY DENTAL HEALTH ACTIVITY
Practice Address - Street 2:
Practice Address - City:FORT STEWART
Practice Address - State:NY
Practice Address - Zip Code:31314
Practice Address - Country:US
Practice Address - Phone:318-791-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant