Individual
DR. ROGER E GRUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3590 HARRISON BLVD., SUITE #5, OGDEN, UT 84403-2012
(801) 621-1440
(801) 394-6833
Mailing address
4895 S 1075 E, OGDEN, UT 84403-4758
(801) 479-6512
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
135117
UT
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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