Organization
SWEET SMILES GRAFTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAVAN GORANTLA (MANAGER)
(262) 377-0807
Entity
Organization
Contact information
Practice address
1300 BRIDGE ST, GRAFTON, WI 53024-1948
(262) 377-0807
Mailing address
1300 BRIDGE ST, GRAFTON, WI 53024-1948
(262) 377-0807
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/15/2014
Last updated
10/01/2020
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