Provider Demographics
NPI:1750020111
Name:GRABOWSKI, THOMAS JACOB (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JACOB
Last Name:GRABOWSKI
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 1:1740 OLD HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-3650
Mailing Address - Country:US
Mailing Address - Phone:248-303-7846
Mailing Address - Fax:
Practice Address - Street 1:26113 HOOVER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1147
Practice Address - Country:US
Practice Address - Phone:586-393-5686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601312122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist