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General NPI Number Information
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NPI Number | 1760312417
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Entity Type | Organization
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Legal Business Name | TROY VAN DER GROEN DMD INC
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Dates
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Enumeration Date | 05/22/2026
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Last Update Date | 05/22/2026
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Provider Practice Location Address
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Address Line | 1150 CIVIC DR STE 101
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City | WALNUT CREEK
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State | CA
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Zip | 94596-3760
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Country | US
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Telephone | 925-940-2530
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Fax |
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Provider Business Mailing Address
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Address Line | 537 34TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-2705
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TROY VAN DER GROEN
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Credential | DMD
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Telephone | 925-348-3118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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