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Individual

MRS. KELLY ANN GROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
6001 WALDEN DR, KNOXVILLE, TN 37919-6355
(865) 588-1294
(865) 588-7708
Mailing address
1110 VALE VIEW RD, KNOXVILLE, TN 37922-5998
(865) 670-9996

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2651
TN

Other

Enumeration date
02/09/2019
Last updated
02/09/2019
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