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1093999179
BRENTLY ALLAN GRIMARD
PUEBLO, CO
NPI
1093999179
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0300X Dentist, Periodontics
(Licence: CO 8681)
Enumeration Date
2007-12-24
Last Update Date
2008-12-02
Business Address
Dr. BRENTLY ALLAN GRIMARD D.D.S., M.S.
3903 OUTLOOK BLVD
PUEBLO, CO 81008-1624
Phone number: 719-545-6485
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Mailing Address
Dr. BRENTLY ALLAN GRIMARD D.D.S., M.S.
3903 OUTLOOK BLVD
PUEBLO, CO 81008-1624
Phone number: 719-545-6485
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