Individual
DR. BERNARD L. GRADOVILLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2800 INGERSOLL AVE, DES MOINES, IA 50312-4013
(515) 243-2412
(515) 243-1248
Mailing address
2800 INGERSOLL AVE, DES MOINES, IA 50312-4013
(515) 243-2412
(515) 243-1248
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7250
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0048066
—
IA
Enumeration date
11/08/2005
Last updated
07/08/2007
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