Organization
ROGER GRANDGENETT DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER HENRY GRANDGENETT D.D.S. (OWNER)
(507) 526-2170
Entity
Organization
Contact information
Practice address
621 E 7TH ST, BLUE EARTH, MN 56013-2516
(507) 526-2170
(507) 526-7437
Mailing address
621 E 7TH ST, BLUE EARTH, MN 56013-2516
(507) 526-2170
(507) 526-7437
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10869
MN
Other
Enumeration date
03/07/2008
Last updated
03/07/2008
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