| Gregory L Glade Dmd Pc | |
|
308 11th St North Port Byron IL 61275-9038 | |
| (309) 523-3325 | |
| (309) 523-9078 |
| Full Name | Gregory L Glade Dmd Pc |
|---|---|
| Speciality | Dentist |
| Location | 308 11th St North, Port Byron, Illinois |
| Authorized Official Name and Position | Bernadette L Glade (SECRETARY OF PC OFFICE MANAGER) |
| Authorized Official Contact | 3095233325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory L Glade Dmd Pc 308 11th St North Port Byron IL 61275-9038 Ph: (309) 523-3325 | Gregory L Glade Dmd Pc 308 11th St North Port Byron IL 61275-9038 Ph: (309) 523-3325 |
| NPI Number | 1609965763 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609965763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
Port Byron Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 11th St, Port Byron, IL 61275 Phone: 309-523-3325 |