Individual
DR. MICHAEL LILLIS GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2550 MOSSIDE BLVD, SUITE 213, MONROEVILLE, PA 15146-3540
(412) 856-8002
Mailing address
2550 MOSSIDE BLVD, SUITE 213, MONROEVILLE, PA 15146-3540
(412) 856-8002
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS-019035-L
PA
Other
Enumeration date
11/01/2005
Last updated
12/10/2007
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