Individual
DR. HOLLY J GRIMSLID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MS
Contact information
Practice address
1200 MAIN ST, LA CROSSE, WI 54601-4102
(608) 782-6778
Mailing address
1200 MAIN ST, LA CROSSE, WI 54601-4102
(608) 782-6778
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5251-015
WI
Other
Enumeration date
01/04/2010
Last updated
01/04/2010
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