Organization
GRANDGENETT FAMILY DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG A GRANDGENETT DDS (OWNER/PRESIDENT)
(515) 956-3426
Entity
Organization
Contact information
Practice address
2208 PHILADELPHIA ST, AMES, IA 50010-8700
(515) 956-3426
(515) 956-3424
Mailing address
2208 PHILADELPHIA ST, AMES, IA 50010-8700
(515) 956-3426
(515) 956-3424
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07931
IA
1223P0221X
Pediatric Dentistry
07946
IA
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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