Glass, Latisha Opal
Glass, Latisha Opal is an individual health care provider with primary practice located at 131 Columbia Ave E , Battle Creek MI 49015-3788. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Glass, Latisha Opal can be contacted via phone (269) 963-9670.Contact Information
Primary practice address
131 Columbia Ave E
Battle Creek MI 49015-3788
Phone: (269) 963-9670
Fax: (269) 963-9672
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2901019115 | Michigan |
Profile Details
| NPI number | 1972565935 |
|---|---|
| LBN Legal business name | Glass, Latisha Opal |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Jan 15th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972565935 | NPPES |
| Michigan | MEDICAID | 4766214 |
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