Individual
M LEWIS GRUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1771 LELIA DR, JACKSON, MS 39216-4820
(601) 362-2660
(601) 362-4064
Mailing address
1771 LELIA DR, JACKSON, MS 39216-4820
(601) 362-2660
(601) 362-4064
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
201483
MS
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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