Gruen, Gordon Ernest

Gruen, Gordon Ernest is an individual health care provider with primary practice located at 780 Ridge Lake Blvd Suite 101, Memphis TN 38120-9426. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Gruen, Gordon Ernest can be contacted via phone (901) 682-8431.

Contact Information

Primary practice address
780 Ridge Lake Blvd Suite 101 Memphis TN 38120-9426
Phone: (901) 682-8431
Fax: (901) 682-2345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X DS 1783 Tennessee

Profile Details

NPI number 1629183116
LBN Legal business name Gruen, Gordon Ernest
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2006
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629183116 NPPES
Tennessee Other 2007914 BLUE CROSS BLUE SHIELD

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