Organization
INSTITUTE OF FACIAL SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANCE F GRENEVICKI DDS,MD,FACS (OWNERDOCTOR)
(321) 674-3900
Entity
Organization
Contact information
Practice address
1093 S WICKHAM RD, WEST MELBOURNE, FL 32904-1652
(321) 674-3900
(321) 722-3303
Mailing address
1093 S WICKHAM RD, WEST MELBOURNE, FL 32904-1652
(321) 674-3900
(321) 722-3303
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
429
FL
Other
Enumeration date
05/24/2007
Last updated
08/24/2010
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