Provider Demographics
NPI:1275846875
Name:GRINHAM, CATHY J (RDH)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:J
Last Name:GRINHAM
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SLAB BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ASSONET
Mailing Address - State:MA
Mailing Address - Zip Code:02702
Mailing Address - Country:US
Mailing Address - Phone:508-813-6034
Mailing Address - Fax:888-236-3536
Practice Address - Street 1:15 SLAB BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ASSONET
Practice Address - State:MA
Practice Address - Zip Code:02702
Practice Address - Country:US
Practice Address - Phone:508-813-6034
Practice Address - Fax:888-236-3536
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH12768124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist