Individual
NIGEL DAVE GRANDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10794 PINES BLVD, SUITE 101, PEMBROKE PINES, FL 33026-3920
(954) 916-9060
(954) 432-6716
Mailing address
10794 PINES BLVD, SUITE 101, PEMBROKE PINES, FL 33026-3920
(954) 916-9060
(954) 432-6716
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN14446
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071682102
—
FL
05
—
075944900
—
FL
Enumeration date
09/24/2006
Last updated
04/28/2014
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