Individual
ANDREI A GRUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
951 PROSPECT AVE, BRONX, NY 10459-2967
(718) 860-8440
Mailing address
548 E 82ND ST, APT 2D, NEW YORK, NY 10028-7133
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
043068
NY
Other
Enumeration date
12/26/2006
Last updated
12/23/2008
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