Individual
TERRY GRUELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 N GRAND AVE, SUITE 301, FORT THOMAS, KY 41075-4107
(859) 441-2369
(859) 442-3222
Mailing address
40 N GRAND AVE, SUITE 301, FORT THOMAS, KY 41075-4107
(859) 441-2369
(859) 442-3222
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4118
KY
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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