Provider Demographics
NPI:1346431608
Name:GRAMPP, CARTER ALAN SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARTER
Middle Name:ALAN
Last Name:GRAMPP
Suffix:SR
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 1:20542 N LAKE PLEASANT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-9749
Mailing Address - Country:US
Mailing Address - Phone:623-334-0012
Mailing Address - Fax:623-376-6201
Practice Address - Street 1:20542 N LAKE PLEASANT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-9749
Practice Address - Country:US
Practice Address - Phone:623-334-0012
Practice Address - Fax:623-376-6201
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice