Individual
AUSTYN C GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MSD
Contact information
Practice address
7133 STONE DR, DAPHNE, AL 36526-4825
(251) 383-3636
(251) 383-3637
Mailing address
703 OLIVE AVE, FAIRHOPE, AL 36532-2805
(251) 383-3636
(251) 383-3637
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6500
AL
1223E0200X
Endodontics
DN27450
FL
1223G0001X
General Practice Dentistry
35040
TX
1223G0001X
General Practice Dentistry
6500
AL
Other
Enumeration date
06/07/2018
Last updated
12/21/2025
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