# 920 NORTH MAIN STREET PROFESSIONAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Taylor Dental Associates & EZ Braces
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346867926
- **Authorized official:** PETER GRUMBOS DMD (OWNER DENTIST)
- **Authorized official phone:** (512) 352-5577

## Contact information

- **Practice address:** 920 N MAIN ST, TAYLOR, TX 76574-3230
- **Practice address phone:** (512) 352-5577
- **Practice address fax:** (512) 352-7416
- **Mailing address:** 920 N MAIN ST, TAYLOR, TX 76574-3230
- **Mailing address phone:** (512) 352-5577
- **Mailing address fax:** (512) 352-7416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2020
- **Last updated:** 06/30/2020