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Organization

WALTER E GLENN DDS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WALTER E GLENN DDS (CORPORATE OFFICER)
(419) 522-2523
Entity
Organization

Contact information

Practice address
13 PARK AVE WEST SUITE 517, WALTER E GLENN DDS INC, MANSFIELD, OH 44902
(419) 522-2523
(419) 522-2523
Mailing address
13 PARK AVE WEST SUITE 517, WALTER E GLENN DDS INC, 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
05/15/2008
Last updated
05/15/2008
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