| Dr. Mary Grote | |
|
301 S Roosevelt Dr Suite A Beaver Dam WI 53916-2439 | |
| (920) 887-8423 | |
| (920) 887-8471 |
| Full Name | Dr. Mary Grote |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 301 S Roosevelt Dr, Beaver Dam, Wisconsin |
| Authorized Official Name and Position | Mary Grote (OWNER) |
| Authorized Official Contact | 9208878423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Mary Grote 301 S Roosevelt Dr Suite A Beaver Dam WI 53916-2439 Ph: (920) 887-8423 | Dr. Mary Grote 301 S Roosevelt Dr Suite A Beaver Dam WI 53916-2439 Ph: (920) 887-8423 |
| NPI Number | 1740336114 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740336114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2582-015 (Wisconsin) | Primary |
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Beaver Dam Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 N Spring St, Beaver Dam, WI 53916 Phone: 920-887-8421 Fax: 920-887-8431 | |
Esser, Krueger & Borja Dds, Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 S University Ave, Beaver Dam, WI 53916 Phone: 920-887-1292 Fax: 920-887-2426 | |
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