Individual
DR. JOHN E GRUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 996-7138
Mailing address
1 W SUPERIOR ST APT 4913, CHICAGO, IL 60610-8867
(312) 475-9492
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
136000123
IL
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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