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Organization
SIMON GROCK DDS APC
Active
Organization
SIMON GROCK DDS APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON GROCK DDS (CORP.PRESIDENT)
(310) 384-3404
Entity
Organization
Contact information
Practice address
4553 GLENCOE AVE # 310, MARINA DEL REY, CA 90292-7906
(310) 384-3404
Mailing address
4553 GLENCOE AVE # 310, MARINA DEL REY, CA 90292-7906
(310) 384-3404
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/02/2014
Last updated
03/01/2016
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