Organization
DR. MARY GROTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY GROTE DDS (OWNER)
(920) 887-8423
Entity
Organization
Contact information
Practice address
301 S ROOSEVELT DR, SUITE A, BEAVER DAM, WI 53916-2439
(920) 887-8423
(920) 887-8471
Mailing address
301 S ROOSEVELT DR, SUITE A, BEAVER DAM, WI 53916-2439
(920) 887-8423
(920) 887-8471
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2582-015
WI
Other
Enumeration date
01/26/2007
Last updated
08/22/2020
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