Individual
MICHELE M GRIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
205 LACKAWANNA AVE, OLYPHANT, PA 18447-1423
(570) 489-1171
Mailing address
205 LACKAWANNA AVE, OLYPHANT, PA 18447-1423
(570) 489-1171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS023282L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0938830
—
PA
01
—
426718
UNITED CONCORDIA
—
Enumeration date
12/05/2006
Last updated
07/08/2007
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