MEDICARE: DR. PUNEETA GROVER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	22DI02547800	NJ

General Provider Information

NPI Number	:	1467886861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PUNEETA GROVER DDS

Provider Business Mailing Address
First Line	:	11 DUNDAR RD STE 102
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-3513
Country	:	US
Telephone Number	:	973-993-7020
Fax Number	:	973-993-7040

Provider Business Practice Location Address
First Line	:	11 DUNDAR RD STE 102
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-3513
Country	:	US
Telephone Number	:	973-993-7020
Fax Number	:	973-993-7040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	03/31/2020

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