Provider Demographics
NPI:1174734149
Name:GLANDER ORTHODONTICS, P.C.
Entity type:Organization
Organization Name:GLANDER ORTHODONTICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GLANDER
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-888-2827
Mailing Address - Street 1:7750 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-5606
Mailing Address - Country:US
Mailing Address - Phone:317-888-2827
Mailing Address - Fax:317-888-2820
Practice Address - Street 1:7750 MADISON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-5606
Practice Address - Country:US
Practice Address - Phone:317-888-2827
Practice Address - Fax:317-888-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008256A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty