Provider Demographics
NPI:1386714210
Name:GRUBER, ALBERT FITZ II (DMD)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:FITZ
Last Name:GRUBER
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1697 LISSON LANE
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017
Mailing Address - Country:US
Mailing Address - Phone:708-212-7995
Mailing Address - Fax:708-339-5567
Practice Address - Street 1:UNIVERSITY OF TENNESSEE COLLEGE OF DENTISTRY
Practice Address - Street 2:875 UNION AVE
Practice Address - City:MEMPHIS
Practice Address - State:IL
Practice Address - Zip Code:38163
Practice Address - Country:US
Practice Address - Phone:901-448-6271
Practice Address - Fax:708-339-5567
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL019-0199951223G0001X
IN12009737A1223G0001X
LA68301223G0001X
TN119791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice