Organization
ETHAN GROUNDS DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN GROUNDS DMD (DR.)
(618) 889-0606
Entity
Organization
Contact information
Practice address
300 SMALL ST STE D, HARRISBURG, IL 62946-3325
(618) 252-1725
Mailing address
910 MARSHALL STREET, HARRISBURG, IL 62946
(618) 889-0606
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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