| NPI | 1477714384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY P GRANTHAM Owner/Physician 850-769-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN4098) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |