Organization
GRIMSLEY DENTAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH W GRIMSLEY DMD (DENTIST)
(229) 758-3345
Entity
Organization
Contact information
Practice address
115 N CUTHBERT ST, COLQUITT, GA 39837-3401
(229) 758-3345
(229) 758-3339
Mailing address
115 N CUTHBERT ST, COLQUITT, GA 39837-3401
(229) 758-3345
(229) 758-3339
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
DN010031
GA
261QD0000X
Dental Clinic/Center
Primary
DN013335
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014425A
—
GA
Enumeration date
09/17/2008
Last updated
09/17/2008
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