MEDICARE: DR. DENNIS ALLEN GLAZER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	30109	OH

General Provider Information

NPI Number	:	1629060215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS ALLEN GLAZER M.D.

Provider Business Mailing Address
First Line	:	3030 TUSCARAWAS ST W
Second Line	:	SUITE 300
City	:	CANTON
State	:	OH
Zip	:	44708-4167
Country	:	US
Telephone Number	:	330-452-1322
Fax Number	:	330-452-4942

Provider Business Practice Location Address
First Line	:	3030 TUSCARAWAS ST W
Second Line	:	SUITE 300
City	:	CANTON
State	:	OH
Zip	:	44708-4167
Country	:	US
Telephone Number	:	330-452-1322
Fax Number	:	330-452-4942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/08/2007

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