Individual provider · Type 1 NPI

Roger Grannum, DDS

Oral and Maxillofacial Surgery (Dentist) · Brooklyn, NY

NPI number 1003993502 Active

Practice location

760 Broadway, Oral Surgery Room 2C320
Brooklyn, NY 11206

Call (718) 963-8000 Map

Fax (718) 599-4912

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X50052633 (NY)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1003993502

Roger Grannum, DDS's National Provider Identifier is 1003993502, issued on Nov 1, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Brooklyn, NY. The record was last updated on Jan 6, 2017.