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1205904208
CHARLES FREDERICK GRANNUM
BROOKLYN, NY
NPI
1205904208
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223P0700X Dentist, Prosthodontics
(Licence: NY 040024)
Enumeration Date
2006-11-30
Last Update Date
2007-07-08
Business Address
-- CHARLES FREDERICK GRANNUM MD
1536 BEDFORD AVE
BROOKLYN, NY 11216-4117
Phone number: 800-376-5566
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Mailing Address
-- CHARLES FREDERICK GRANNUM MD
PO BOX 29889
NEW YORK, NY 10087-9889
Phone number: 800-376-5566
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