Organization
1601 2ND STREET GALLUP PROFESSIONAL, LLC
Active
Other names
Sundance Dental Care of Gallup
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER GRMBOS DDS (OWNER/DENTIST)
(505) 722-4422
Entity
Organization
Contact information
Practice address
1601 S SECOND ST, GALLUP, NM 87301-5816
(505) 722-4422
(505) 722-2060
Mailing address
1601 S SECOND ST, GALLUP, NM 87301-5816
(505) 722-4422
(505) 722-2060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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