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Individual

DR. ROGER N GROSSBARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
14455 W GRAND AVE, SUITE 102, SURPRISE, AZ 85374-7196
(623) 546-2080
Mailing address
17492 N HORSESHOE DR, SURPRISE, AZ 85374-6238
(623) 975-4422

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1287
AZ

Other

Enumeration date
06/07/2006
Last updated
10/17/2007
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