Individual
DR. LANCE FRANCIS GRENEVICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS, FACS
Contact information
Practice address
1093 S WICKHAM RD, THE INSTITUTE OF FACIAL SURGERY, WEST MELBOURNE, FL 32904-1652
(321) 674-3900
(321) 722-3303
Mailing address
1093 S WICKHAM RD, THE INSTITUTE OF FACIAL SURGERY, WEST MELBOURNE, FL 32904-1652
(321) 674-3900
(321) 722-3303
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN15027
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME77063
FL
208600000X
Surgery Physician
ME77063
FL
Other
Enumeration date
02/18/2006
Last updated
01/21/2014
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