Individual
DR. ANDREW JACOB GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, DMD
Contact information
Practice address
55 FRUIT ST., WANG AMBULATORY BLDG SUITE230, BOSTON, MA 02114-2696
(617) 726-2740
Mailing address
55 FRUIT ST BLDG SUITE230, BOSTON, MA 02114-2696
(617) 726-2740
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10858402-8903
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
10858402-9925
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
11022
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1859764
MA
Other
Enumeration date
08/07/2018
Last updated
12/10/2024
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