Provider Demographics
NPI:1750487708
Name:GROVE, WILLIAM STUART III (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STUART
Last Name:GROVE
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:12685 CRABAPPLE RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-6339
Mailing Address - Country:US
Mailing Address - Phone:770-475-3700
Mailing Address - Fax:770-664-2284
Practice Address - Street 1:12685 CRABAPPLE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6339
Practice Address - Country:US
Practice Address - Phone:770-475-3700
Practice Address - Fax:770-664-2284
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA87671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice