Individual
DR. RICHARD BLACKWOOD GRUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1805 LASKIN RD, SUITE 100, VIRGINIA BEACH, VA 23454-4538
(757) 321-1870
(757) 963-0468
Mailing address
1805 LASKIN RD, SUITE 100, VIRGINIA BEACH, VA 23454-4538
(757) 321-1870
(757) 963-0468
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008590
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401008590
DENTAL LICENSE
VA
Enumeration date
11/22/2006
Last updated
07/08/2007
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