Individual
GLENN RICHARD WATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
306 W WASHINGTON AVE, SUITE 204, JACKSON, MI 49201-2169
(517) 782-1467
(517) 782-3659
Mailing address
306 W WASHINGTON AVE, SUITE 204, JACKSON, MI 49201-2169
(517) 782-1467
(517) 782-3659
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901009803
MI
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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