| Jerry D Gragg Dds | |
|
3489 N 76th St Milwaukee WI 53222-3968 | |
| (414) 445-4111 | |
| (414) 445-4103 |
| Full Name | Jerry D Gragg Dds |
|---|---|
| Speciality | Dentist |
| Location | 3489 N 76th St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Linda Mcdermott (OFFICE MANAGER) |
| Authorized Official Contact | 4144454111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry D Gragg Dds 3489 N 76th St Milwaukee WI 53222-3968 Ph: (414) 445-4111 | Jerry D Gragg Dds 3489 N 76th St Milwaukee WI 53222-3968 Ph: (414) 445-4111 |
| NPI Number | 1548575335 |
|---|---|
| Provider Enumeration Date | 08/17/2010 |
| Last Update Date | 08/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548575335 | NPI | - | NPPES |
| 33408000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2473 (Wisconsin) | Primary |
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