Provider Demographics
NPI:1568595312
Name:GEORGE J GROBINS DDS PS
Entity Type:Organization
Organization Name:GEORGE J GROBINS DDS PS
Other - Org Name:HEALTH CENTERED FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JURIS
Authorized Official - Last Name:GROBINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-564-2722
Mailing Address - Street 1:7810 WEST 27TH ST
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4111
Mailing Address - Country:US
Mailing Address - Phone:253-564-2722
Mailing Address - Fax:253-564-0321
Practice Address - Street 1:7810 WEST 27TH ST
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4111
Practice Address - Country:US
Practice Address - Phone:253-564-2722
Practice Address - Fax:253-564-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0038101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0085205OtherDEPT OF LABORER&INDUST
L0791OtherCITY BUSINESS LICENSE
PA587870OtherUNITED CONCORDIA INS CO
600363819OtherDEPT OF REVENUE
AGO994815OtherDRUG ENFORCEMENT AGENCY