920 Lobo Canyon Grants Professional, LLC
NPI #1477218964 in Grants, New Mexico
Provider Information
- NPI Number
- 1477218964
- Entity Type
- Organization
- Organization Name
- 920 Lobo Canyon Grants Professional, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 1, 2021
- Last Updated
- Nov 1, 2021
Practice Location
- Address
- 920 LOBO CANYON RD
- City
- Grants
- State
- New Mexico
- ZIP Code
- 87020-2173
- Phone
- (505) 722-4422
Authorized Official
- Name
- PETER GRUMBOS, DDS
- Title
- DENTIST/OWNER
- Phone
- (505) 722-4422
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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