Provider Demographics
NPI:1003176272
Name:CHRISTOPHER J. GLAPA
Entity type:Organization
Organization Name:CHRISTOPHER J. GLAPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:GLAPA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-734-7345
Mailing Address - Street 1:W3132 VAN ROY RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-3982
Mailing Address - Country:US
Mailing Address - Phone:920-734-7345
Mailing Address - Fax:920-734-0850
Practice Address - Street 1:W3132 VAN ROY RD
Practice Address - Street 2:UNIT 2
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-3982
Practice Address - Country:US
Practice Address - Phone:920-734-7345
Practice Address - Fax:920-734-0850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22901223P0700X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty