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Organization
PETER GRUMBOS DDS SHALLOTTE PLLC
Active
Organization
PETER GRUMBOS DDS SHALLOTTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BROOKS (CREDENTIALING MANAGER)
(252) 292-1349
Entity
Organization
Contact information
Practice address
343 WHITEVILLE RD NW, SHALLOTTE, NC 28470-4507
(910) 754-4507
Mailing address
343 WHITEVILLE RD NW, SHALLOTTE, NC 28470-4507
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/14/2023
Last updated
04/20/2023
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