Organization
GREGORY P GRANTHAM DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY P GRANTHAM DMD (OWNER/PHYSICIAN)
(850) 769-3253
Entity
Organization
Contact information
Practice address
340 W 23RD ST, SUITE A, PANAMA CITY, FL 32405-7600
(850) 769-3253
(850) 784-0057
Mailing address
340 W 23RD ST, SUITE A, PANAMA CITY, FL 32405-7600
(850) 769-3253
(850) 784-0057
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN4098
FL
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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