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Individual

MICHAEL W GRANGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
745 BRADLEY DR, FAYETTEVILLE, GA 30214-2030
(770) 461-4142
(770) 719-8862
Mailing address
745 BRADLEY DR, FAYETTEVILLE, GA 30214-2030
(770) 461-4142
(770) 719-8862

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
011413
GA

Other

Enumeration date
12/08/2006
Last updated
07/09/2012
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