Individual
DR. KENT W. GRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
237 WEST MULBERRY, OGDEN, IA 50212-0813
(515) 275-2250
(515) 275-2816
Mailing address
422 OLYMPIC DR, WATERLOO, IA 50701-4972
(319) 232-6239
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6265
IA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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