Individual
HALEY GROELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2115 W WASHINGTON STREET, WEST BEND, WI 53059
(262) 335-0822
Mailing address
2115 W WASHINGTON ST, WEST BEND, WI 53095-2205
(262) 335-0822
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
600005315
WI
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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