Provider Demographics
NPI:1770544645
Name:GRUBLER, DAVID BRUCE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRUCE
Last Name:GRUBLER
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 1:333 W HATCHER RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-2466
Mailing Address - Country:US
Mailing Address - Phone:602-943-7217
Mailing Address - Fax:602-943-7218
Practice Address - Street 1:333 W HATCHER RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2466
Practice Address - Country:US
Practice Address - Phone:602-943-7217
Practice Address - Fax:602-943-7218
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice