Individual
GRANVILLE ANTHONY SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
90 MAIN ST, SARANAC LAKE, NY 12983-5735
(518) 891-0104
(518) 891-7130
Mailing address
90 MAIN ST, SARANAC LAKE, NY 12983-5735
(518) 891-0104
(518) 891-7130
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051943
NY
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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