Organization
MCDONALD & GRUCHALLA, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE GUY GRUCHALLA DDS (CO-OWNER, DENTIST)
(701) 235-1261
Entity
Organization
Contact information
Practice address
1231 27TH ST S, FARGO, ND 58103-8722
(701) 235-1261
Mailing address
1231 27TH ST S, FARGO, ND 58103-8722
(701) 235-1261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1957
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41376
—
ND
Enumeration date
02/12/2007
Last updated
08/22/2020
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