Provider Demographics
NPI:1073930764
Name:KATHERINE A. GRIGG DDS PA
Entity Type:Organization
Organization Name:KATHERINE A. GRIGG DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRIGG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-443-6816
Mailing Address - Street 1:3589 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-8788
Mailing Address - Country:US
Mailing Address - Phone:828-544-5085
Mailing Address - Fax:
Practice Address - Street 1:598 OAK AVE
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-2728
Practice Address - Country:US
Practice Address - Phone:828-765-9002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty