Individual
DR. TRAVIS LEE GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9419 STATE ROAD 403, CHARLESTOWN, IN 47111
(812) 256-0606
(812) 256-0600
Mailing address
7028 PLUM CREEK DR, SELLERSBURG, IN 47172-8919
(812) 748-0057
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010738A
IN
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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