Individual
JOHN S GRANT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
6217 S PACKARD AVE, CUDAHY, WI 53110-3096
(414) 764-5550
(414) 764-8175
Mailing address
6217 S PACKARD AVE, CUDAHY, WI 53110-3096
(414) 764-5550
(414) 764-8175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001334
WI
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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