Provider Demographics
NPI:1003546557
Name:GRONCKI-WHITE DENTAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:GRONCKI-WHITE DENTAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-206-5152
Mailing Address - Street 1:110 DAVID LN
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1562
Mailing Address - Country:US
Mailing Address - Phone:215-479-8018
Mailing Address - Fax:
Practice Address - Street 1:350 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2707
Practice Address - Country:US
Practice Address - Phone:215-822-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty