Individual
DR. MICHAEL R. GROEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
506 GROVER ST, #108, LYNDEN, WA 98264-1960
(360) 354-6036
(360) 354-5586
Mailing address
506 GROVER ST, #108, LYNDEN, WA 98264-1960
(360) 354-6036
(360) 354-5586
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5575
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5078001
—
WA
Enumeration date
11/07/2006
Last updated
07/08/2007
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