Organization
TSO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY GRUELLE (OWNER)
(859) 441-2369
Entity
Organization
Contact information
Practice address
40 N GRAND AVE, SUITE 301, FORT THOMAS, KY 41075-4107
(859) 441-2369
(859) 442-3222
Mailing address
40 N GRAND AVE, SUITE 301, FORT THOMAS, KY 41075-4107
(859) 441-2369
(859) 442-3222
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4118
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
8737
KY
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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