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Individual

WILLIAM ARTHUR GROSDIDIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(651) 468-9356
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D13681
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D13681
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/03/2016
Last updated
03/18/2025
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