Individual
KENT GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1852 BLUFFTON RD, FORT WAYNE, IN 46809-1306
(260) 479-1086
(260) 478-4621
Mailing address
13214 BOARSTONE CV, FORT WAYNE, IN 46845-8730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010892A
IN
Other
Enumeration date
10/05/2006
Last updated
07/09/2007
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