Organization
GRANT GASTINEAU, DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT GASTINEAU DDS (CHIEF OFFICER)
(620) 431-4823
Entity
Organization
Contact information
Practice address
32 W MAIN ST, CHANUTE, KS 66720-1701
(620) 431-4823
Mailing address
32 W MAIN ST, CHANUTE, KS 66720-1701
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
61398
KS
261QD0000X
Dental Clinic/Center
—
KS
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
05/26/2017
Last updated
05/26/2017
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