Individual provider · Type 1 NPI

Glen Frank Petrick, DDS MS

Orthodontics and Dentofacial Orthopedics Dentistry · Sugar Land, TX

NPI number 1790882702 Active

Practice location

4724 Sweetwater Boulevard, Suite 103
Sugar Land, TX 77479-3150

Call (281) 313-8890 Map

Fax (281) 313-8895

Mailing address

4724 Sweetwater Blvd, Suite 103
Sugar Land, TX 77479-3150

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	9534 (TX)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1790882702

Glen Frank Petrick, DDS MS's National Provider Identifier is 1790882702, issued on Sep 20, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Sugar Land, TX. The record was last updated on Jul 8, 2007.