Provider Demographics
NPI:1205008497
Name:KAIL, GROBMYER AND LEONARD DENTISTRY
Entity Type:Organization
Organization Name:KAIL, GROBMYER AND LEONARD DENTISTRY
Other - Org Name:PREMEIR DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-663-9999
Mailing Address - Street 1:6058 HIGHWAY 412 S
Mailing Address - Street 2:
Mailing Address - City:BELLS
Mailing Address - State:TN
Mailing Address - Zip Code:38006-3908
Mailing Address - Country:US
Mailing Address - Phone:731-663-9999
Mailing Address - Fax:731-663-0510
Practice Address - Street 1:6058 HIGHWAY 412 S
Practice Address - Street 2:
Practice Address - City:BELLS
Practice Address - State:TN
Practice Address - Zip Code:38006-3908
Practice Address - Country:US
Practice Address - Phone:731-663-9999
Practice Address - Fax:731-663-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty