Provider Demographics
NPI:1225151145
Name:GRIERSON, DOUGLAS ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ALAN
Last Name:GRIERSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 CENTER CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:OH
Mailing Address - Zip Code:45370-9000
Mailing Address - Country:US
Mailing Address - Phone:937-862-4185
Mailing Address - Fax:
Practice Address - Street 1:3869 INDIAN RIPPLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-3410
Practice Address - Country:US
Practice Address - Phone:937-427-1749
Practice Address - Fax:937-427-4616
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH179311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice