| NPI | 1245293604 |
|---|---|
| Professional Name | GLENN STEWART WATERS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OH 30022099) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2007-07-08 |