Individual
DR. MICHAEL JOSEPH VON GRUBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1100 FLORIDA AVE, NEW ORLEANS, LA 70119-2714
(504) 619-8770
Mailing address
325 FOCIS ST, METAIRIE, LA 70005-3433
(225) 772-4499
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
S-633
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S-633
—
LA
Enumeration date
07/01/2010
Last updated
07/01/2010
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