| Doctor Name: | DR. DAVID MITCHELL GLASS |
| NPI Number: | 1053545665 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.D.S. |
| License Number: | 3732 |
| Business Practice Address: | 5301 Cowhorn Creek Road Texarkana, TX - 75503 |
| Business Phone Number: | 3188616999 |
| Business Fax Number: | |
| Mailing Address: | 821 Ontario St, SHREVEPORT |
| State: | LA |
| Postal Code: | 711061118 |
| Phone Number: | 9018331141 |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2009 |
| NPI Last Update Date: | 06/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 3732 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |