Provider Demographics
NPI:1487820874
Name:RICHARD W. GRUNDER, DDS, INC.
Entity Type:Organization
Organization Name:RICHARD W. GRUNDER, DDS, INC.
Other - Org Name:TODAY;S DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:563-785-4541
Mailing Address - Street 1:501 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:IA
Mailing Address - Zip Code:52747-7749
Mailing Address - Country:US
Mailing Address - Phone:563-785-4541
Mailing Address - Fax:563-785-4687
Practice Address - Street 1:501 9TH AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:IA
Practice Address - Zip Code:52747-7749
Practice Address - Country:US
Practice Address - Phone:563-785-4541
Practice Address - Fax:563-785-4687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA7031261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental