Individual
HENK JOHANNES GROBBELAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
810 BRAYDEN PKWY, STE 109, FORT MILL, SC 29708
(803) 810-1609
Mailing address
12217 GREYMORE CT, CHARLOTTE, NC 28277-2494
(704) 743-7522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13025
NC
1223G0001X
General Practice Dentistry
Primary
DGD.10174
SC
Other
Enumeration date
06/03/2022
Last updated
10/13/2022
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