Individual
DR. JOHNNY MICHAEL GROELING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1500 SUMMER ST, STAMFORD, CT 06905-5132
(203) 303-9802
Mailing address
650 W 42ND ST APT 1421, NEW YORK, NY 10036-4370
(631) 352-7746
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13037
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2020
Last updated
08/10/2021
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