Provider Demographics
NPI:1275674269
Name:GROVER, NEERAJ (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEERAJ
Middle Name:
Last Name:GROVER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4946 QUILL CT
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3699
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3906 TAMPA RD
Practice Address - Street 2:SUITE C
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3100
Practice Address - Country:US
Practice Address - Phone:813-814-2933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN130-801223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry