Provider Demographics
NPI:1770050544
Name:WILLIAM B GROSS DDS OF GREENSBORO LLC
Entity type:Organization
Organization Name:WILLIAM B GROSS DDS OF GREENSBORO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-404-1798
Mailing Address - Street 1:2733 HORSE PEN CREEK ROAD
Mailing Address - Street 2:107
Mailing Address - City:GREENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27513-9742
Mailing Address - Country:US
Mailing Address - Phone:201-404-1798
Mailing Address - Fax:
Practice Address - Street 1:2733 HORSE PEN CREEK RD STE 107
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8538
Practice Address - Country:US
Practice Address - Phone:336-854-9270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty