Individual
DR. JEROME F GRADOVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
557 N 155TH PLZ, OMAHA, NE 68154-3775
(402) 391-5511
(402) 391-4954
Mailing address
557 N 155TH PLZ, OMAHA, NE 68154-3775
(402) 391-5511
(402) 391-4954
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5586
NE
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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