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Individual

DR. JERALD ALLEN GROTSTEIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
100 RIDGE VIEW DR, SUITE 103, CARY, NC 27511-5589
(919) 467-2203
Mailing address
100 RIDGE VIEW DR, SUITE 103, CARY, NC 27511-5589

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4139
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
93434
NC
Enumeration date
12/19/2005
Last updated
07/08/2007
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