Provider Demographics
NPI:1538300355
Name:GRUBBS, THOMAS D (DDS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:D
Last Name:GRUBBS
Suffix:
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 1:229 DENTAL SCIENCE BLDG S
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1001
Mailing Address - Country:US
Mailing Address - Phone:319-335-7217
Mailing Address - Fax:
Practice Address - Street 1:26 ST JAMES CIR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1971
Practice Address - Country:US
Practice Address - Phone:913-302-1482
Practice Address - Fax:913-302-1482
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30425390200000X
KS60670122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program