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Individual
MR. TIMOTHY M GRINDER
Active
Individual
MR. TIMOTHY M GRINDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5595
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
570722
UNITED CONCORIDA INS
—
01
—
93439
BLUE CROSS BLUE SHIELD
NC
Enumeration date
10/05/2006
Last updated
02/11/2014
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