Provider Demographics
NPI:1285753855
Name:GLASSMAN, BARRY H (DMD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:H
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 W HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-4328
Mailing Address - Country:US
Mailing Address - Phone:610-435-6724
Mailing Address - Fax:610-435-3482
Practice Address - Street 1:1329 W HAMILTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-4328
Practice Address - Country:US
Practice Address - Phone:610-435-6724
Practice Address - Fax:610-435-3482
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0182051223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02610000OtherPA BLUE CROSS ID #
PA153-605Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PAT72214Medicare UPIN