Individual
DR. TARA LYNN GRZETIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MS
Contact information
Practice address
2055 FOXFIELD RD, ST CHARLES, IL 60174-1442
(630) 584-6555
Mailing address
720 N OLD WORLD 3RD ST APT 807, MILWAUKEE, WI 53203-2245
(630) 715-3377
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0000011264
TN
Other
Enumeration date
07/22/2020
Last updated
01/11/2023
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