Organization
TERRY V. GRUELLE P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY VERNON GRUELLE D.M.D. (PRESIDENT)
(859) 391-4000
Entity
Organization
Contact information
Practice address
40 N GRAND AVE, SUITE 301, FORT THOMAS, KY 41075-4107
(859) 441-2369
(859) 442-3222
Mailing address
40 N GRAND AVE, SUITE 301, FORT THOMAS, KY 41075-4107
(859) 441-2369
(859) 442-3222
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4118
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6004118300
—
KY
Enumeration date
12/24/2006
Last updated
08/22/2020
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