Individual
DR. JOHN P GRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
515 W 6TH ST, JACKSONVILLE, FL 32206-4324
(904) 253-1200
(904) 253-1956
Mailing address
900 UNIVERSITY BLVD N, MC - 75, JACKSONVILLE, FL 32211-9230
(904) 253-2062
(904) 253-1942
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN5728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0718874-00
—
FL
05
—
071887400
—
FL
Enumeration date
06/03/2006
Last updated
02/26/2013
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