| NPI | 1205291242 |
|---|---|
| Doing Business As | DIAMOND G DENTAL |
| Entity Type | Organization |
| Authorized Contact | STEPHEN BRAD GRANDY President 307-723-0448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1386) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-29 |