Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 0401415451 | VA |
NPI | 1962812305 |
---|---|
Provider Name | Dr. Sarah H Glass |
First Address | Richmond, VA 23298 |
Second Address | Richmond, VA 23298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 24/10/2018 |