Willow Grove Family Dental

NPI #1417399965 in Plymouth, Minnesota

Provider Information

NPI Number: 1417399965
Entity Type: Organization
Organization Name: Willow Grove Family Dental
Subpart: Yes (part of a larger organization)
Parent Organization: GR SERVICES
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 25, 2013
Last Updated: Jun 20, 2018

Practice Location

Address: 28 NATHAN LN N
City: Plymouth
State: Minnesota
ZIP Code: 55441-6306
Phone: (763) 544-5555

Authorized Official

Name: MR. ALEX GRUDSKY
Title: OWNER - PRESIDENT
Phone: (763) 694-0222

Specialties & Taxonomy Codes

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

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