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Organization
NICK GROTE FAMILY DENTAL PA
Active
Organization
NICK GROTE FAMILY DENTAL PA
Active
Parent organization
NICK GROTE FAMILY DENTAL PA
Other names
Grote Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
NICK GROTE FAMILY DENTAL PA
Authorized official
NICHOLAS GROTE DDS (OWNER/DENTIST)
(479) 806-6556
Entity
Organization
Contact information
Practice address
611 JEFFERSON ST, VAN BUREN, AR 72956-5159
(479) 474-2701
(479) 474-2701
Mailing address
611 JEFFERSON ST, VAN BUREN, AR 72956-5159
(479) 474-2701
(479) 474-3977
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
3881
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200268608
—
AR
05
—
201489631
—
AR
Enumeration date
07/05/2017
Last updated
03/17/2018
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