Individual
ROBERT GRASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4881 SUGAR MAPLE DR, ATTN: 88 MEDICAL GROUP, WPAFB, OH 45433-5529
(372) 579-5889
Mailing address
88TH MEDICAL GROUP, 4881 SUGAR MAPLE DR., WPAFB, OH 45433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
35607
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
30.027678
OH
390200000X
Student in an Organized Health Care Education/Training Program
35607
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2019
Last updated
08/02/2024
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