Individual
ISABEL TAMANAHA GRUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
145 VERMILYEA AVE, SUITE #27, NEW YORK, NY 10034
(212) 567-1729
(212) 567-0909
Mailing address
145 VERMILYEA AVE, SUITE #27, NEW YORK, NY 10034
(212) 567-1729
(212) 567-0909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
042409
NY
1223G0001X
General Practice Dentistry
DI17024
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01286108
—
NY
Enumeration date
05/22/2007
Last updated
07/08/2007
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