Head, Glenn Robert

Head, Glenn Robert is an sole proprietor health care provider with primary practice located at 6 Pointe Cir , Greenville SC 29615-3506. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Head, Glenn Robert can be contacted via phone (864) 233-1234.

Contact Information

Primary practice address
6 Pointe Cir Greenville SC 29615-3506
Fax: (864) 298-8009
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 2868 South Carolina

Profile Details

NPI number 1790771871
LBN Legal business name Head, Glenn Robert
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 23rd, 2005
Last updated Oct 23rd, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790771871 NPPES
South Carolina MEDICAID ZA9481

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