| NPI | 1992864375 |
|---|---|
| Other Name | MICHAEL WADE GRANGER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 011413) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-07-09 |