Todd Clinton Groesbeck, D.M.D Valid NPI

Individual provider · General Practice Dentistry · Provo, UT

NPI

1780939348

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

8372408-9922 (UT)

Sex

Male

Sole proprietor

No

Enumerated

2012-07-19

Last updated

2012-07-20