Provider Demographics
NPI:1568488989
Name:DEAN A. GROTH, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:DEAN A. GROTH, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GROTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-885-8247
Mailing Address - Street 1:32100 TELEGRAPH RD
Mailing Address - Street 2:SUITE 195
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2452
Mailing Address - Country:US
Mailing Address - Phone:248-885-8247
Mailing Address - Fax:248-644-8225
Practice Address - Street 1:32100 TELEGRAPH RD
Practice Address - Street 2:SUITE 195
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-2452
Practice Address - Country:US
Practice Address - Phone:248-885-8247
Practice Address - Fax:248-644-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty