Individual
GRANT S NASSIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4647 RIDGE RD, BROOKLYN, OH 44144-3318
(216) 351-6600
Mailing address
4647 RIDGE RD, BROOKLYN, OH 44144-3318
(216) 351-6600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30027149
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018820
—
OH
Enumeration date
04/11/2023
Last updated
07/16/2024
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