1346431608 NPI number — DR. CARTER ALAN GRAMPP SR. D.D.S.

Table of content: DR. CARTER ALAN GRAMPP SR. D.D.S. (NPI 1346431608)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346431608 NPI number — DR. CARTER ALAN GRAMPP SR. D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAMPP
Provider First Name:
CARTER
Provider Middle Name:
ALAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346431608
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/01/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20542 N LAKE PLEASANT RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85382-9749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-334-0012
Provider Business Mailing Address Fax Number:
623-376-6201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20542 N LAKE PLEASANT RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
PEORIA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85382-9749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-334-0012
Provider Business Practice Location Address Fax Number:
623-376-6201
Provider Enumeration Date:
08/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2443 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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