Individual
DR. NICHOLAS G GRENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
194 MISSILE AVE, MINOT, ND 58705
(701) 723-5615
Mailing address
194 MISSILE AVE, MINOT AFB, ND 58705
(517) 449-2272
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901601314
MI
Other
Enumeration date
04/27/2022
Last updated
02/01/2024
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