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Organization

LITTLEGRINS , P.L.L.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH DREW GALLEMORE D.D.S (OWNER)
(928) 782-4708
Entity
Organization

Contact information

Practice address
2179 W 24TH ST STE B, YUMA, AZ 85364-6163
(928) 782-4708
(928) 782-2212
Mailing address
2179 W 24TH ST STE B, YUMA, AZ 85364-6163
(928) 782-4708
(928) 782-2212

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4390
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
155269002
AZ
Enumeration date
07/03/2012
Last updated
07/03/2012
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