Provider Demographics
NPI:1124396635
Name:GROUNDS & MEGGERS FAMILY DENTISTRY, P.A.
Entity Type:Organization
Organization Name:GROUNDS & MEGGERS FAMILY DENTISTRY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:GROUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-753-5564
Mailing Address - Street 1:4720 CAMP ROBINSON ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118
Mailing Address - Country:US
Mailing Address - Phone:501-753-5564
Mailing Address - Fax:501-753-8650
Practice Address - Street 1:4720 CAMP ROBINSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-3632
Practice Address - Country:US
Practice Address - Phone:501-753-5564
Practice Address - Fax:501-753-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR22081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty