Individual
DR. MICHAEL H GROUSD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1360 W IRVINGTON RD STE 180, TUCSON, AZ 85746-4102
(520) 777-1428
Mailing address
PO BOX 1450, TUBAC, AZ 85646-1450
(520) 310-4705
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DO7926
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80022385
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/28/2008
Last updated
01/14/2019
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