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Organization

SMILEBLISS BY DR. G.

Active
Parent organization
DR, GRANDISON DMD
Organization subpart
Yes

Provider details

NPI number
Legal business name
DR, GRANDISON DMD
Authorized official
MR. NIGEL GRANDISON DMD (OFFICER)
(954) 326-2947
Entity
Organization

Contact information

Practice address
10117 CLEARY BOULEVARD, PLANTATION, FL 33324
(954) 326-2947
Mailing address
10117 CLEARY BOULEVARD, PLANTATION, FL 33324
(954) 326-2947

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
075944900
FL
Enumeration date
04/11/2023
Last updated
04/11/2023
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