Provider Demographics
NPI:1164658829
Name:GROVER, ALISON ELAINE (DDS,)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:ELAINE
Last Name:GROVER
Suffix:
Gender:F
Credentials:DDS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 GALLEGOS CIR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-2503
Mailing Address - Country:US
Mailing Address - Phone:303-229-2125
Mailing Address - Fax:
Practice Address - Street 1:570 GALLEGOS CIR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-2503
Practice Address - Country:US
Practice Address - Phone:303-229-2125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT41701223P0221X
CO000099121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1942483524OtherOFFICE NATIONAL PROVIDER IDENTIFIER