Middaugh, Glen D
Middaugh, Glen D is an sole proprietor health care provider with primary practice located at 2801 Anton Road , Terre Haute IN 47803. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Middaugh, Glen D can be contacted via phone (812) 877-6724.Contact Information
Primary practice address
2801 Anton Road
Terre Haute IN 47803
Phone: (812) 877-6724
Fax: (812) 877-6150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 12010393 | Indiana |
Profile Details
| NPI number | 1053316901 |
|---|---|
| LBN Legal business name | Middaugh, Glen D |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Nov 18th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053316901 | NPPES |
| Indiana | MEDICAID | 200415160A |
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