Individual
DR. TYLER MATTHEW GRISAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1515 WISCONSIN AVE, GRAFTON, WI 53024-1962
(262) 377-4130
Mailing address
1515 WISCONSIN AVE, GRAFTON, WI 53024-1962
(262) 377-4130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001277-15
WI
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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