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General NPI Number Information
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NPI Number | 1083065437
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Entity Type | Organization
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Legal Business Name | MICHAEL A. GROSS, DDS, PLLC
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 1600 E WOODLAWN RD STE 361
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City | CHARLOTTE
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State | NC
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Zip | 28209-2276
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Country | US
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Telephone | 704-594-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 E WOODLAWN RD SUITE 361
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City | CHARLOTTE
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State | NC
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Zip | 28209-2276
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Country | US
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Telephone | 704-594-5595
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | JENNIFER BISHOPP
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Credential |
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Telephone | 704-242-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 9984
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License Number State | NC
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