NPI | 1023174554 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREW DEAN GRUVER President 410-766-2744 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MD 5755) |
Additional Taxonomies | 122300000X Dentist (Licence: MD 7170) |
122300000X Dentist (Licence: MD 13735) | |
Enumeration Date | 2006-12-29 |
Last Update Date | 2025-09-11 |