Individual
NICOLE A. GRESCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRDA/RDA
Contact information
Practice address
1789 WOODLANE DR, #D, WOODBURY, MN 55125-3910
(651) 738-1284
Mailing address
1625 FROST AVE UNIT A, MAPLEWOOD, MN 55109-4611
(651) 251-3859
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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