MEDICARE: JEFFREY B. GROUT, DDS, P.C.

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	1223G0001X	General Practice Dentistry	3753	CO
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1053377242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY B. GROUT, DDS, P.C.

Provider Business Mailing Address
First Line	:	8 W DRY CREEK CIR STE 101
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80120-4477
Country	:	US
Telephone Number	:	303-730-1222
Fax Number	:	303-730-2096

Provider Business Practice Location Address
First Line	:	8 W DRY CREEK CIR STE 101
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80120-4477
Country	:	US
Telephone Number	:	303-730-1222
Fax Number	:	303-730-2096

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFFREY GROUT
Credential	:	DDS
Telephone Number	:	303-918-7752

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	01/11/2018

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