| Gary L Granseth | |
|
1201 Gilmore Ave Winona MN 55987-2424 | |
| (507) 452-8668 | |
| Not Available |
| Full Name | Gary L Granseth |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1201 Gilmore Ave, Winona, Minnesota |
| Authorized Official Name and Position | Gary Lee Granseth (OWNER) |
| Authorized Official Contact | 5074528668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary L Granseth 1201 Gilmore Ave Winona MN 55987-2424 Ph: (507) 452-8668 | Gary L Granseth 1201 Gilmore Ave Winona MN 55987-2424 Ph: (507) 452-8668 |
| NPI Number | 1558974816 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 08/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558974816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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