Organization · Type 2 NPI
Roger Grannum Dds, P.c.
Oral and Maxillofacial Surgery (Dentist) · Brooklyn, NY
NPI number
1568600757
Active
Practice location
730 Broadway
Brooklyn, NY 11206-4403
Mailing address
131 Knollwood Dr
Watchung, NJ 07069-6245
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 052633 (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.
2 other providers at this address
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About NPI 1568600757
Roger Grannum Dds, P.c.'s National Provider Identifier is 1568600757, issued on Jan 27, 2009. 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 Sep 29, 2011.