Individual
CAL GRUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
303 S OSAGE AVE, TIPTON, MO 65081-8470
(563) 513-9612
Mailing address
1127 ROCK CUT RD, HAZEL GREEN, WI 53811-9719
(563) 513-9612
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
1223G0001X
General Practice Dentistry
Primary
2023024441
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2023
Last updated
06/26/2023
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