Individual
GRANT KOSHAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 SCIENCE DR STE 100, MADISON, WI 53711-1064
(608) 308-2950
Mailing address
5329 N HENKE RD, MILTON, WI 53563-8680
(608) 295-5121
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001574-15
WI
Other
Enumeration date
03/11/2024
Last updated
09/17/2024
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