Nicki L Childress-Grubb, DMD

NPI #1184741829 in Pompton Lakes, New Jersey

Provider Information

NPI Number: 1184741829
Entity Type: Individual
Name: Nicki L Childress-Grubb, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Mar 26, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 825 RINGWOOD AVE
City: Pompton Lakes
State: New Jersey
ZIP Code: 07442-2215
Phone: (973) 831-8950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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