Von Gruben, Michael Joseph
Von Gruben, Michael Joseph is an individual health care provider with primary practice located at 1100 Florida Ave , New Orleans LA 70119-2714. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Von Gruben, Michael Joseph can be contacted via phone (504) 619-8770.Contact Information
Primary practice address
1100 Florida Ave
New Orleans LA 70119-2714
Phone: (504) 619-8770
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | S-633 | Louisiana |
Profile Details
| NPI number | 1871804146 |
|---|---|
| LBN Legal business name | Von Gruben, Michael Joseph |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2010 |
| Last updated | Jul 1st, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871804146 | NPPES |
| Louisiana | MEDICAID | S-633 |
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