Provider Demographics
NPI:1861508723
Name:GLASS, WALTER LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:LEE
Last Name:GLASS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 S PIERCE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4553
Mailing Address - Country:US
Mailing Address - Phone:303-979-4981
Mailing Address - Fax:303-933-6937
Practice Address - Street 1:7325 S PIERCE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4553
Practice Address - Country:US
Practice Address - Phone:303-979-4981
Practice Address - Fax:303-933-6937
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice