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Organization
MA DENTAL
Active
Organization
MA DENTAL
Active
Other names
Bay Smile Docs
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SCOTT GRANDY DMD (DENTIST/OWNER)
(850) 271-2341
Entity
Organization
Contact information
Practice address
530 FLORIDA AVENUE, LYNN HAVEN, FL 32444-1736
(850) 271-2341
(850) 271-0679
Mailing address
530 FLORIDA AVENUE, LYNN HAVEN, FL 32444-1736
(850) 271-2341
(850) 271-0679
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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