Provider Demographics
NPI:1528413937
Name:GROVER, SIMRAN
Entity Type:Individual
Prefix:
First Name:SIMRAN
Middle Name:
Last Name:GROVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIMRAN
Other - Middle Name:
Other - Last Name:GROVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS,MSD,CAGS
Mailing Address - Street 1:7 FARNHAM CIR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-2865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 FARNHAM CIR
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-2865
Practice Address - Country:US
Practice Address - Phone:978-866-4767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL127761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice