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1235577495
TUCKER WILLIAM GROSS
WATERTOWN, SD
NPI
1235577495
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: SD DH1175)
Enumeration Date
2013-06-10
Last Update Date
2013-06-10
Business Address
-- TUCKER WILLIAM GROSS RDH
1306 S LAKE DR
WATERTOWN, SD 57201-5450
Phone number: 605-222-4489
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Mailing Address
-- TUCKER WILLIAM GROSS RDH
1306 S LAKE DR
WATERTOWN, SD 57201-5450
Phone number: 605-222-4489
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