MRS. Stacie Lee Gross, RDH

NPI #1700116316 in Brainerd, Minnesota

Provider Information

NPI Number: 1700116316
Entity Type: Individual
Name: MRS. Stacie Lee Gross, RDH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH
Enumeration Date: Jan 4, 2010
Last Updated: Jan 4, 2010

Practice Location

Address: 501 WEST COLLEGE DRIVE
City: Brainerd
State: Minnesota
ZIP Code: 56401
Phone: (218) 855-8272

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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