| NPI | 1013039528 |
|---|---|
| Doing Business As | GRANT DAVIS GRIBBLE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOHN DAVIS Vice President 505-898-1976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2016-05-23 |