730 New Albany Professional PLLC

Organization Active NPI General Practice Dentistry · New Albany, MS

NPI 1710691241 · NPPES record last updated Jan 10, 2023

Key facts

NPI
1710691241
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
730 NEW ALBANY PROFESSIONAL PLLC
Practice address
731 Coulter Dr
New Albany, MS 38652
Phone
(662) 534-4397
Fax
(662) 534-6599
NPI assigned
Jan 10, 2023
Organization subpart
No

Authorized official

Name
Peter Grumbos, DDS
Title
Owner
Phone
(662) 534-4397

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
730 New Albany Professional PLLC (2 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

731 Coulter Dr
New Albany, MS 38652

Mailing address

731 Coulter Dr
New Albany, MS 38652
Phone (662) 534-4397

Other names

  • Rowan Family Dentistry Doing business as

Other providers in New Albany, MS

All providers in New Albany, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.