Provider Demographics
NPI:1346354966
Name:NEAL F GRONICH DDS, PLLC
Entity Type:Organization
Organization Name:NEAL F GRONICH DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:GRONICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-581-1300
Mailing Address - Street 1:7598 N MESA ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3517
Mailing Address - Country:US
Mailing Address - Phone:915-581-1300
Mailing Address - Fax:915-581-0824
Practice Address - Street 1:7598 N MESA ST
Practice Address - Street 2:SUITE 208
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3517
Practice Address - Country:US
Practice Address - Phone:915-581-1300
Practice Address - Fax:915-581-0824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty