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1063580181
TIMOTHY T GRANTHAM
VALDOSTA, GA
NPI
1063580181
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: GA 10547)
Enumeration Date
2006-11-30
Last Update Date
2007-07-08
Business Address
-- TIMOTHY T GRANTHAM DMD
103 W CRANFORD AVE
VALDOSTA, GA 31602-2930
Phone number: 229-249-0717
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Mailing Address
-- TIMOTHY T GRANTHAM DMD
103 W CRANFORD AVE
VALDOSTA, GA 31602-2930
Phone number: 229-249-0717
Copy
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