Individual
HEIDI JO GRUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAP RDH
Contact information
Practice address
19230 SW CONZELMANN RD, SHERWOOD, OR 97140-8707
(503) 997-3489
Mailing address
19230 SW CONZELMANN RD, SHERWOOD, OR 97140-8707
(503) 997-3489
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H4842
OR
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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