Provider Information for 1336149368
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Dr. JEFFREY BLAKE GROUT DDS
Sex: Male
NPI: 1336149368
Last Updated: 2018-01-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1336149368 | ||||||||||||
| Enumeration Date | 2005-08-01 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 8 W DRY CREEK CIR #101 LITTLETON, CO 80120-4477 United States Phone: 303-730-1222 | Fax:303-730-2096 | ||||||||||||
| Primary Practice Address | 8 W DRY CREEK CIR #101 LITTLETON, CO 80120-4477 United States Phone: 303-730-1222 | Fax:303-730-2096 | ||||||||||||
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