| 110 Regent Court College Professional Pllc | |
|
110 Regent Ct Ste 100 State College PA 16801-7966 | |
| (814) 231-0110 | |
| (814) 231-0118 |
| Full Name | 110 Regent Court College Professional Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 110 Regent Ct Ste 100, State College, Pennsylvania |
| Authorized Official Name and Position | Peter Grumbos (OWNER/DENTIST) |
| Authorized Official Contact | 5057224422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 110 Regent Court College Professional Pllc 110 Regent Ct Ste 100 State College PA 16801-7966 Ph: (814) 231-0110 | 110 Regent Court College Professional Pllc 110 Regent Ct Ste 100 State College PA 16801-7966 Ph: (814) 231-0110 |
| NPI Number | 1366173551 |
|---|---|
| Provider Enumeration Date | 06/20/2022 |
| Last Update Date | 06/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366173551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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