Organization
PETER GRUMBOS DDS RANDOLPH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY BROOKS (CREDENTIALING MANAGER)
(252) 292-1349
Entity
Organization
Contact information
Practice address
2711 RANDOLPH RD STE 205, CHARLOTTE, NC 28207-2027
(704) 377-2503
(704) 377-6032
Mailing address
12200 W FINCH AVE, MIDDLESEX, NC 27557-7427
(252) 292-1349
(919) 278-2657
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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