Organization
PETER GRUMBOS DDS REIDSVILLE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BROOKS (CREDENTIALING MANAGER)
(252) 292-1349
Entity
Organization
Contact information
Practice address
1109 S PARK DR, REIDSVILLE, NC 27320-5513
(336) 342-0889
(336) 344-8669
Mailing address
1109 S PARK DR, REIDSVILLE, NC 27320-5513
(336) 342-0889
(336) 344-8669
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
03/01/2023
Last updated
11/28/2023
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