Provider Demographics
NPI:1821249442
Name:GROSKO, GREGORY MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MATTHEW
Last Name:GROSKO
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 1:2960 SKIPPACK PIKE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19490-0544
Mailing Address - Country:US
Mailing Address - Phone:610-222-0450
Mailing Address - Fax:610-222-0451
Practice Address - Street 1:2960 SKIPPACK PIKE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:PA
Practice Address - Zip Code:19490-0544
Practice Address - Country:US
Practice Address - Phone:610-222-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023119L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist