Dr. John E Grubb, DDS
Dentist, Orthodontics and Dentofacial Orthopedics in Chicago, IL. Individual provider (NPI-1).
NPI number1154533461
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1154533461
- Entity type
- Individual (NPI-1)
- Name
- Dr. John E Grubb
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 7, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 136000123 | IL | Yes |
Practice location
801 S Paulina StChicago, IL 60612-7210
Phone 312-996-7138
Mailing address
1 W Superior St Apt 4913Chicago, IL 60610-8867
Phone 312-475-9492
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