920 North Main Street Professional, Pllc

NPI #1346867926 in Taylor, Texas

Provider Information

NPI Number: 1346867926
Entity Type: Organization
Organization Name: 920 North Main Street Professional, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 30, 2020
Last Updated: Jun 30, 2020

Practice Location

Address: 920 N MAIN ST
City: Taylor
State: Texas
ZIP Code: 76574-3230
Phone: (512) 352-5577

Authorized Official

Name: PETER GRUMBOS, DMD
Title: OWNER DENTIST
Phone: (512) 352-5577

Specialties & Taxonomy Codes

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

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