| Organization Name: | YVETTE GLINA, DDS, LLC |
| NPI Number: | 1366624306 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YVETTE GLINA (OWNER) |
| Mailing Address: | 1 Sheldon Rd 62 Humphrey Street Entrance Marblehead |
| State: | MA US |
| Postal Code: | 019452024 |
| Phone Number: | 7816313400 |
| Fax Number: | 7816313464 |
| NPI Enumeration Date: | 12/01/2007 |
| NPI Last Update Date: | 12/01/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 21031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |