Individual
DR. LOUIS MICHAEL GRILLON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
436 CHICOPEE ST, CHICOPEE, MA 01013-1941
(413) 533-0528
Mailing address
436 CHICOPEE ST, CHICOPEE, MA 01013-1941
(413) 533-0528
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15603
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15603
DENTAL LICENSE #
MA
Enumeration date
12/12/2005
Last updated
07/08/2007
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