Organization
KEVIN J. GRANT D.D.S.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN J GRANT D.D.S. (OWNER)
(718) 523-7679
Entity
Organization
Contact information
Practice address
8752A PARSONS BLVD, JAMAICA, NY 11432-3317
(718) 523-7679
(718) 523-7689
Mailing address
8752A PARSONS BLVD, JAMAICA, NY 11432-3317
(718) 523-7679
(718) 523-7689
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
044444
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01383568
—
NY
Enumeration date
11/04/2015
Last updated
11/04/2015
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