OrganizationActive
1601 2nd Street Gallup Professional, LLC
NPI 1386309870 · General Practice Dentistry · Gallup, NM
Provider details
- NPI number
- 1386309870
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Peter Grmbos, Owner/Dentist(505) 722-4422
Specialties & taxonomies
Dental Providers
Practice location
1601 S Second St
Gallup, NM 87301-5816
Phone: (505) 722-4422
Fax: (505) 722-2060
Approximate (ZIP-level) locationGet directions
Mailing address
1601 S Second St
Gallup, NM 87301-5816
Other names (DBA / former)
- Doing business as
- Sundance Dental Care of Gallup
Registry dates
- Enumerated
- 2021-11-01
- Last updated
- 2021-11-01
- Certified
- 2021-10-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.