NPI | 1902814692 |
---|---|
Former Legal Business Name | GARY L GRILLI DDS & GARY F GRILLI DMD |
Entity Type | Organization |
Authorized Contact | GARY L GRILLI Owner 860-644-1509 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CT 8941) |
Additional Taxonomies | 122300000X Dentist (Licence: CT 4251) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2020-08-22 |