MEDICARE: WILLIAM P GROHOL DMD

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	DS-025502-L	PA

General Provider Information

NPI Number	:	1376678581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM P GROHOL DMD

Provider Business Mailing Address
First Line	:	229 PAOLI PIKE
Second Line	:
City	:	MALVERN
State	:	PA
Zip	:	19355-2709
Country	:	US
Telephone Number	:	610-405-9048
Fax Number	:

Provider Business Practice Location Address
First Line	:	327 E GAY ST
Second Line	:	PARKWAY PLAZA
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-2759
Country	:	US
Telephone Number	:	601-696-9244
Fax Number	:	610-696-9243

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	11/30/2011

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