Mattlage, Glenn Taylor
Mattlage, Glenn Taylor is an sole proprietor health care provider with primary practice located at 4415 66Th St Suite 112, Lubbock TX 79414-4809. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Mattlage, Glenn Taylor can be contacted via phone (806) 797-1275.Contact Information
Primary practice address
4415 66Th St Suite 112
Lubbock TX 79414-4809
Phone: (806) 797-1275
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | DD1382 | New Mexico |
| Dental Providers / Periodontics | 1223P0300X | 12592 | Texas |
Profile Details
| NPI number | 1184603243 |
|---|---|
| LBN Legal business name | Mattlage, Glenn Taylor |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Aug 26th, 2014 - about 10 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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