Individual
MR. WALTER EDWARD GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13 PARK AVENUE WEST, SUITE 517, MANSFIELD, OH 44902
(419) 522-2523
(419) 522-2523
Mailing address
13 PARK AVENUE WEST, SUITE 517, MANSFIELD, OH 44902
(419) 522-2523
(419) 522-2523
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18506
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665034
—
OH
Enumeration date
07/05/2006
Last updated
07/08/2007
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