Individual
DR. KELLY GRUETZMACHER GROSKOPF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
W381N8165 ROLLING RIVER CIR, OCONOMOWOC, WI 53066-8950
(715) 459-3222
Mailing address
1951 COMMERCE PKWY, FORT ATKINSON, WI 53538-3139
(920) 563-4415
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001308-15
WI
Other
Enumeration date
06/02/2016
Last updated
03/03/2017
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