Provider Demographics
NPI:1043224298
Name:GRIMALDI, ASHLEIGH (DMD)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:GRIMALDI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-2643
Mailing Address - Country:US
Mailing Address - Phone:724-628-2330
Mailing Address - Fax:
Practice Address - Street 1:320 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-2643
Practice Address - Country:US
Practice Address - Phone:724-628-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0365661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice