Provider Demographics
NPI:1437244365
Name:GRUMMONS, DUANE C (DDS, MSD)
Entity type:Individual
Prefix:
First Name:DUANE
Middle Name:C
Last Name:GRUMMONS
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 N NEVADA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1286
Mailing Address - Country:US
Mailing Address - Phone:509-232-7223
Mailing Address - Fax:509-328-5949
Practice Address - Street 1:9425 N NEVADA ST STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1286
Practice Address - Country:US
Practice Address - Phone:509-232-7223
Practice Address - Fax:509-328-5949
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000079271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics