Provider Demographics
NPI:1760465355
Name:GROSH, THOMAS BAYARD III (DDS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BAYARD
Last Name:GROSH
Suffix:III
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 1:1430 MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:PA
Mailing Address - Zip Code:17512-8724
Mailing Address - Country:US
Mailing Address - Phone:717-426-1867
Mailing Address - Fax:
Practice Address - Street 1:1430 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:PA
Practice Address - Zip Code:17512-8724
Practice Address - Country:US
Practice Address - Phone:717-426-1867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0183681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice