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Individual

DR. LISA M GABRISH GRABOVAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S., M.S.

Contact information

Practice address
1495 POPE CT, CHESTERTON, IN 46304-5301
(219) 926-1068
(219) 929-1944
Mailing address
1495 POPE CT, CHESTERTON, IN 46304-5301
(219) 926-1068
(219) 929-1944

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12008971
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100209830
IN
01
749490
UNITED CONCORDIA INS. CO.
Enumeration date
05/11/2006
Last updated
07/21/2022
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