# DR. SCOTT A GRASSO DDS PC

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

## Provider details

- **NPI number:** 1699879783
- **Authorized official:** DR. SCOTT A GRASSO DDS (PRESIDENT/DENTIST)
- **Authorized official phone:** (765) 287-8040

## Contact information

- **Practice address:** 3212 W JACKSON ST, MUNCIE, IN 47304-4314
- **Practice address phone:** (765) 287-8040
- **Practice address fax:** (765) 282-9332
- **Mailing address:** 3212 W JACKSON ST, MUNCIE, IN 47304-4314
- **Mailing address phone:** (765) 287-8040
- **Mailing address fax:** (765) 282-9332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12009964 | IN | Yes |

## Other

- **Enumeration date:** 09/11/2006
- **Last updated:** 08/22/2020