Provider Demographics
NPI:1740178326
Name:GRAMS FAMILY DENTAL LLC
Entity type:Organization
Organization Name:GRAMS FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:262-424-7875
Mailing Address - Street 1:12320 W OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2833
Mailing Address - Country:US
Mailing Address - Phone:414-321-6890
Mailing Address - Fax:
Practice Address - Street 1:12320 W OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2833
Practice Address - Country:US
Practice Address - Phone:414-321-6890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental