# DR. JOHN P GRIM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1457399214
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DN5728 | FL | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 02/26/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0718874-00 | — | FL |
| 05 | — | 071887400 | — | FL |