| Grant Road Dental | |
|
1040 Grant Rd Ste 105 Mountain View CA 94040-3274 | |
| (650) 938-8127 | |
| (650) 230-4925 |
| Full Name | Grant Road Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1040 Grant Rd Ste 105, Mountain View, California |
| Authorized Official Name and Position | Robert Rutner (OWNER) |
| Authorized Official Contact | 6509388127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant Road Dental 15075 Los Gatos Blvd Ste 120 Los Gatos CA 95032-2049 Ph: (408) 884-8155 | Grant Road Dental 1040 Grant Rd Ste 105 Mountain View CA 94040-3274 Ph: (650) 938-8127 |
| NPI Number | 1659896827 |
|---|---|
| Provider Enumeration Date | 08/09/2017 |
| Last Update Date | 08/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659896827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 33512 (California) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
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