| Gluckstadt Family Dentistry, Pa | |
|
1716 Highway 51 Ste G Madison MS 39110-5020 | |
| (601) 790-9245 | |
| (601) 790-9236 |
| Full Name | Gluckstadt Family Dentistry, Pa |
|---|---|
| Speciality | Dentist |
| Location | 1716 Highway 51 Ste G, Madison, Mississippi |
| Authorized Official Name and Position | Robert Jeremiah Hauptman (OWNER) |
| Authorized Official Contact | 6017909245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gluckstadt Family Dentistry, Pa 1716 Highway 51 Ste G Madison MS 39110-5020 Ph: (601) 790-9245 | Gluckstadt Family Dentistry, Pa 1716 Highway 51 Ste G Madison MS 39110-5020 Ph: (601) 790-9245 |
| NPI Number | 1497009922 |
|---|---|
| Provider Enumeration Date | 11/06/2012 |
| Last Update Date | 11/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497009922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3581-11 (Mississippi) | Primary |
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