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GABRIEL GRISHAM

Individual Provider (NPI-1) Active

Dentist, Oral and Maxillofacial Surgery

Provider Information

NPI Number
1720570393
Provider Type
Individual Provider (NPI-1)
Status
Active

Contact & Location

Address
43 SMITH RD, NEWPORT, RI, 028411006
Phone
(301) 875-4494

Specialties & Taxonomies

Dentist, Oral and Maxillofacial Surgery License: VA #0401416112
Dentist, Oral and Maxillofacial Surgery Primary License: RI #DEN03731

All Addresses

LOCATION

43 SMITH RD

NEWPORT, RI, 028411006

(301) 875-4494

MAILING

PSC 475 BOX 1935

FPO, AP, 963509998