Individual
GRADY SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
28811 S TAMIAMI TRL STE 14, BONITA SPRINGS, FL 34134-3201
(239) 947-5858
(239) 947-4511
Mailing address
28811 S TAMIAMI TRL STE 14, BONITA SPRINGS, FL 34134-3201
(239) 947-5858
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20601
FL
Other
Enumeration date
05/28/2014
Last updated
09/22/2022
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