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Individual

HANSROLF HILDEBRANDT GRUENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
830 METCALF ST, SEDRO WOOLLEY, WA 98284
(360) 855-0351
(360) 855-9357
Mailing address
830 METCALF ST, SEDRO WOOLLEY, WA 98284
(360) 855-0351
(360) 855-9357

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00005832
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5007604
WA
01
5312GR
REGENCE
WA
01
757623
UNITED CONCORDIA
01
82145
LABOR & INDUSTRIES
WA
Enumeration date
12/06/2006
Last updated
07/08/2007
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