920 Lobo Canyon Grants Professional, LLC

Organization Active NPI General Practice Dentistry · Grants, NM

NPI 1477218964 · NPPES record last updated Nov 1, 2021

Key facts

NPI
1477218964
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
920 LOBO CANYON GRANTS PROFESSIONAL, LLC
Practice address
920 Lobo Canyon Rd
Grants, NM 87020-2173
Phone
(505) 722-4422
NPI assigned
Nov 1, 2021
Organization subpart
No

Authorized official

Name
Peter Grumbos, DDS
Title
Dentist/Owner
Phone
(505) 722-4422

National Provider Directory

Locations

920 Lobo Canyon Rd
Ste 6
Grants, NM 87020
Phone (801) 580-4081

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

920 Lobo Canyon Rd
Grants, NM 87020-2173

Mailing address

920 Lobo Canyon Rd
Grants, NM 87020-2173
Phone (505) 722-4422

Other names

  • Sundance Dental Care of Grants Doing business as

Other providers in Grants, NM

All providers in Grants, NM · General Practice Dentistry in New Mexico

Sources for this page

Verify at the official NPI Registry.