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Organization
GRAND RIVER DENTAL LLC
Active
Organization
GRAND RIVER DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE C KISER (OFFICE MANAGER)
(435) 313-1302
Entity
Organization
Contact information
Practice address
9500 MENTOR AVE STE 110, MENTOR, OH 44060-8712
(435) 313-1302
Mailing address
1034 W JACKSON ST, PAINESVILLE, OH 44077-2529
(435) 313-1302
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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