Individual
LORI A GRETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1931 N 8TH STREET, SHEBOYGAN, WI 53081
(920) 783-6633
Mailing address
2636 N 5TH STREET, SHEBOYGAN, WI 53081
(920) 457-9187
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2524-16
WI
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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