Individual
DR. STAS GRANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.D.
Contact information
Practice address
800 MORNING STAR DR STE A, SONORA, CA 95370-9260
(209) 532-5788
Mailing address
800 MORNING STAR DR STE A, SONORA, CA 95370-9260
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401413384
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00203854
CO
Other
Enumeration date
11/07/2011
Last updated
12/06/2023
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