Glisten Dental LLC

NPI #1104553478 in Gilbert, Arizona

Provider Information

NPI Number: 1104553478
Entity Type: Organization
Organization Name: Glisten Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 5, 2022
Last Updated: Jun 8, 2024

Practice Location

Address: 4365 E PECOS RD STE 127
City: Gilbert
State: Arizona
ZIP Code: 85295-8052
Phone: (480) 331-4955

Authorized Official

Name: DR. REVAN DAWOOD, DMD
Title: DENTIST
Phone: (623) 262-4372

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Periodontics — Periodontics	1223P0300X
Dentist - Prosthodontics — Prosthodontics	1223P0700X
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Clinic/Center - Sleep Disorder Diagnostic — Sleep Disorder Diagnostic	261QS1200X
Dentist - General Practice — General Practice	1223G0001X	Primary

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