OrganizationActive
Dr. Mary Grote
NPI 1740336114 · Oral and Maxillofacial Surgery (Dentist) · Beaver Dam, WI
Provider details
- NPI number
- 1740336114
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Mary Grote, Owner(920) 887-8423
- License
- 2582-015 (WI)
Specialties & taxonomies
Dental Providers
Practice location
301 S Roosevelt Dr
Suite a
Beaver Dam, WI 53916-2439
Phone: (920) 887-8423
Fax: (920) 887-8471
Approximate (ZIP-level) locationGet directions
Mailing address
301 S Roosevelt Dr
Beaver Dam, WI 53916-2439
Registry dates
- Enumerated
- 2007-01-26
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.