Healthcare Provider Details

I. General information

NPI: 1326011578
Provider Name (Legal Business Name): GROVE AND PLATT DENTAL ASSOCIATES PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 S THIRD STREET SUITE 300
GRIMES IA
50111
US

IV. Provider business mailing address

1541 S THIRD STREET SUITE 300
GRIMES IA
50111
US

V. Phone/Fax

Practice location:
  • Phone: 515-986-4001
  • Fax: 515-986-4037
Mailing address:
  • Phone: 515-986-4001
  • Fax: 515-986-4037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6772
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8358
License Number StateIA

VIII. Authorized Official

Name: DR. JENNIFER L GROVE
Title or Position: DENTIST OWNER
Credential:
Phone: 515-986-4001