Individual
DR. WALTER GLENN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2526 SHALLOWFORD RD, SUITE A, MARIETTA, GA 30066-3053
(770) 924-7826
(770) 924-2822
Mailing address
2526 SHALLOWFORD RD, SUITE A, MARIETTA, GA 30066-3053
(770) 924-7826
(770) 924-2822
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN009753
GA
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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