Individual
DR. ZACHARY T GRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
498 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3708
(860) 648-2848
Mailing address
498 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3708
(860) 648-2848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010565
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004011136
—
CT
Enumeration date
06/30/2011
Last updated
06/25/2012
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