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Individual

DONALD LEON GRIDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
424 9TH ST, SUITE #1, COLUMBUS, GA 31901-2895
(706) 327-9936
Mailing address
424 9TH ST, SUITE #1, COLUMBUS, GA 31901-2895
(706) 327-9936

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012469
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000966908B
GA
05
000966908E
GA
Enumeration date
07/28/2006
Last updated
12/17/2014
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