Individual
DR. GINA RAE GRENFELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
30 N 18TH AVE # 1, STURGEON BAY, WI 54235-3207
(920) 743-6976
Mailing address
30 N 18TH AVE # 1, STURGEON BAY, WI 54235-3207
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6892-15
WI
Other
Enumeration date
04/30/2012
Last updated
07/10/2014
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