Organization
1661 W 2ND CORSICANA PROFESSIONAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER GRUMBOS DMD (OWNER)
(214) 259-7000
Entity
Organization
Contact information
Practice address
1661 W 2ND AVE, CORSICANA, TX 75110-4107
(903) 872-1661
Mailing address
1661 W 2ND AVE, CORSICANA, TX 75110-4107
(903) 872-1661
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
04/20/2020
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