Provider Demographics
NPI:1588768048
Name:GLASSETT, NELSON D (DDS)
Entity type:Individual
Prefix:DR
First Name:NELSON
Middle Name:D
Last Name:GLASSETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11576 SOUTH STATE STREET
Mailing Address - Street 2:SUITE 1203
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7118
Mailing Address - Country:US
Mailing Address - Phone:801-619-8664
Mailing Address - Fax:801-619-8787
Practice Address - Street 1:11576 S STATE ST
Practice Address - Street 2:SUITE 1203
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-6431
Practice Address - Country:US
Practice Address - Phone:801-619-8664
Practice Address - Fax:801-619-8787
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT042970659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist