| Walter E Glenn Dds Inc | |
|
13 Park Ave West Suite 517 Walter E Glenn Dds Inc Mansfield OH 44902 | |
| (419) 522-2523 | |
| (419) 522-2523 |
| Full Name | Walter E Glenn Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 13 Park Ave West Suite 517, Mansfield, Ohio |
| Authorized Official Name and Position | Walter E Glenn (CORPORATE OFFICER) |
| Authorized Official Contact | 4195222523 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walter E Glenn Dds Inc 13 Park Ave West Suite 517 Walter E Glenn Dds Inc Mansfield OH 44902 Ph: (419) 522-2523 | Walter E Glenn Dds Inc 13 Park Ave West Suite 517 Walter E Glenn Dds Inc Mansfield OH 44902 Ph: (419) 522-2523 |
| NPI Number | 1518134824 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 05/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518134824 | NPI | - | NPPES |
| 0665034 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 18506 (Ohio) | Primary |
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