Provider Demographics
NPI:1992871610
Name:GLADURA, DEAN ROBERT (DDS)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:ROBERT
Last Name:GLADURA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 EMSWILER WAY
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062
Mailing Address - Country:US
Mailing Address - Phone:740-927-3981
Mailing Address - Fax:740-927-2666
Practice Address - Street 1:124 EMSWILER WAY
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062
Practice Address - Country:US
Practice Address - Phone:740-927-3981
Practice Address - Fax:740-927-2666
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300195101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice