Misty Gail Gretencord D.D.S

NPI 1659565299 - Dentist - 122300000X

NPI Details
NPI 1659565299
Gender Female
Enumeration Date 08/28/2007
Last Updated 10/20/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
4315 COMMERCE DR STE 310
LAFAYETTE IN, 47905-3824, US
Phone (765) 588-0220
Fax
Business Location
1300 HASP WAY
LAFAYETTE IN, 47905-8520, US
Phone
Fax
Toxanomy
Taxonomy Code 122300000X
License State Texas
License Number 25549
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According to our database, Misty Gail Gretencord D.D.S NPI is 1659565299, taxonomy code is 122300000X and license number is 25549, license state is located at Texas. Misty Gail Gretencord D.D.S physically located at 4315 Commerce Dr Ste 310, Lafayette IN, 47905-3824. NPI Number Misty Gail Gretencord D.D.S has the Individual type.

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1659565299 NPI number is provided on an as is basis without warranty of any kind. 1659565299 is maintained by the National Plan & Provider Enumeration System. The contents of Misty Gail Gretencord D.D.S are for informational purposes only.