Individual
GABRIEL GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
43 SMITH RD, NEWPORT, RI 02841-1006
(301) 875-4494
Mailing address
PSC 475 BOX 1935, FPO, AP 96350-9998
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401416112
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN03731
RI
Other
Enumeration date
05/30/2018
Last updated
09/12/2024
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