Provider Demographics
NPI:1316633035
Name:GRUVER, BETH ANN (RDH BS)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:GRUVER
Suffix:
Gender:F
Credentials:RDH BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3612
Mailing Address - Country:US
Mailing Address - Phone:410-375-3686
Mailing Address - Fax:
Practice Address - Street 1:20 COURTHOUSE SQ STE 105
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2337
Practice Address - Country:US
Practice Address - Phone:301-424-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4045124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist