Individual
DR. JESSE G GRANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
800 MEDICAL CENTER DR STE 490, FAIRMONT, MN 56031-4575
(507) 432-3199
Mailing address
800 MEDICAL CENTER DR STE 490, FAIRMONT, MN 56031-4575
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14646
MN
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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