Individual
GRADY M TWOHIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
211 S NATIONAL AVE, FOND DU LAC, WI 54935-5359
(920) 921-8565
(920) 921-0121
Mailing address
211 S NATIONAL AVE, FOND DU LAC, WI 54935-5359
(920) 921-8565
(920) 921-0121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5872015
WI
Other
Enumeration date
12/30/2005
Last updated
01/21/2015
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