Individual
GREGORY GERALD GRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
739 HAUSSLER RD, OMAK, WA 98841-9547
(509) 826-5040
(509) 826-9436
Mailing address
PO BOX 1841, OMAK, WA 98841-1841
(509) 826-4050
(509) 826-9436
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7526
WA
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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