Provider Demographics
NPI:1346247996
Name:GRUBB, FOY EUGENE JR (DDS)
Entity Type:Individual
Prefix:
First Name:FOY
Middle Name:EUGENE
Last Name:GRUBB
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 PINEDALE RD
Mailing Address - Street 2:STE C
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2020
Mailing Address - Country:US
Mailing Address - Phone:336-282-4022
Mailing Address - Fax:336-282-2437
Practice Address - Street 1:2707 PINEDALE RD
Practice Address - Street 2:STE C
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2020
Practice Address - Country:US
Practice Address - Phone:336-282-4022
Practice Address - Fax:336-282-2437
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8993438Medicaid
NC93438OtherBLUE CROSS BLUE SHIELD