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Organization
FEDERICO GRANDE DDS, MD, PA
Active
Organization
FEDERICO GRANDE DDS, MD, PA
Active
Parent organization
FEDERICO GRANDE DDS, MD, PA
Other names
Grande Oral Specialties
Organization subpart
Yes
Provider details
NPI number
Legal business name
FEDERICO GRANDE DDS, MD, PA
Authorized official
DR. FEDERICO GRANDE (OWNER)
(772) 510-5900
Entity
Organization
Contact information
Practice address
650 SE INDIAN ST STE 2, STUART, FL 34997-5565
(772) 510-5900
Mailing address
650 SE INDIAN ST STE 2, STUART, FL 34997-5565
(772) 510-5900
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/27/2022
Last updated
01/10/2023
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