Glenn, Walter Edward
Glenn, Walter Edward is an individual health care provider with primary practice located at 13 Park Avenue West Suite 517, Mansfield OH 44902. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Glenn, Walter Edward can be contacted via phone (419) 522-2523.Contact Information
Primary practice address
13 Park Avenue West Suite 517
Mansfield OH 44902
Phone: (419) 522-2523
Fax: (419) 522-2523
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 18506 | Ohio |
Profile Details
| NPI number | 1093746679 |
|---|---|
| LBN Legal business name | Glenn, Walter Edward |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093746679 | NPPES |
| Ohio | MEDICAID | 0665034 |
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