# GREGORY G GRILLO DDS PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437280922
- **Authorized official:** GREG GRILLO DDS (OWNER)
- **Authorized official phone:** (509) 826-4050

## Contact information

- **Practice address:** 739 HAUSSLER RD, OMAK, WA 98841-9548
- **Practice address phone:** (509) 826-4050
- **Practice address fax:** (509) 826-0806
- **Mailing address:** PO BOX 1841, 739 HAUSSLER RD, OMAK, WA 98841-1841
- **Mailing address phone:** (509) 826-4050
- **Mailing address fax:** (509) 826-0806

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7526 | WA | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 08/22/2020