Organization
KENNETH GRUNDSET PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH GRUNDEST DDS (OWNER)
(727) 282-1970
Entity
Organization
Contact information
Practice address
9634 107TH AVE N, LARGO, FL 33773-4503
(727) 851-6870
Mailing address
9634 107TH AVE N, LARGO, FL 33773-4503
(727) 851-6870
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN 04596
FL
Other
Enumeration date
05/05/2014
Last updated
11/25/2014
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