Individual
DENISE L GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7300 MOON RIDGE CT, FORT WORTH, TX 76133-8335
(682) 371-8289
Mailing address
7300 MOON RIDGE CT, FORT WORTH, TX 76133-8335
(682) 371-8289
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1474782
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33-1035302
NON-SURGICAL HAIR REPLACEMENT
TX
Enumeration date
03/06/2024
Last updated
03/06/2024
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