Provider Demographics
NPI:1376678581
Name:GROHOL, WILLIAM P (DMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:GROHOL
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 1:229 PAOLI PIKE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2709
Mailing Address - Country:US
Mailing Address - Phone:610-405-9048
Mailing Address - Fax:
Practice Address - Street 1:327 E GAY ST
Practice Address - Street 2:PARKWAY PLAZA
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2759
Practice Address - Country:US
Practice Address - Phone:601-696-9244
Practice Address - Fax:610-696-9243
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-025502-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice