Organization
GRAND FAMILY DENTISTRY. COM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BRADLEY GRAND D.D.S. (PRESIDENT)
(985) 778-0096
Entity
Organization
Contact information
Practice address
2083 3RD ST, MANDEVILLE, LA 70471-6426
(985) 231-5796
(985) 624-8881
Mailing address
700 ASBURY DR, MANDEVILLE, LA 70471-1844
(985) 231-5796
(985) 624-8881
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
122300000X
LA
Other
Enumeration date
03/27/2007
Last updated
10/17/2016
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