Baron Grutter DDS LLC
Dentist, General Practice in Gladstone, MO. Organization (NPI-2).
NPI number1306130091
StatusActive
Last updated in NPPESMay 31, 2011
Details
- NPI
- 1306130091
- Entity type
- Organization (NPI-2)
- Legal business name
- Baron Grutter DDS LLC
- Organization subpart
- No
- Enumeration date
- May 31, 2011
- Last updated
- May 31, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 2010016293 | MO | Yes |
Practice location
5601 Ne Antioch RdSuite 5
Gladstone, MO 64119-2300
Phone 816-455-1200 · Fax 816-455-1021
Mailing address
5601 Ne Antioch RdSuite 5
Gladstone, MO 64119-2300
Phone 816-401-2561
Authorized official
Baron G Grutter
Owner/Dentist
8164551200
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