Provider Demographics
NPI:1275947384
Name:JOHN G. GRIFFIN,DDS,P.A.
Entity Type:Organization
Organization Name:JOHN G. GRIFFIN,DDS,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-205-7739
Mailing Address - Street 1:784 E US HIGHWAY 74
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-7524
Mailing Address - Country:US
Mailing Address - Phone:910-205-7745
Mailing Address - Fax:910-205-7739
Practice Address - Street 1:784 E US HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-7524
Practice Address - Country:US
Practice Address - Phone:910-205-7745
Practice Address - Fax:910-205-7739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty