Provider Demographics
NPI:1376815332
Name:PAPATHOMA GRIAS, EFTHYMIA (DDS)
Entity Type:Individual
Prefix:
First Name:EFTHYMIA
Middle Name:
Last Name:PAPATHOMA GRIAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6477 CHERRY MEADOW DR SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-7350
Mailing Address - Country:US
Mailing Address - Phone:616-891-8990
Mailing Address - Fax:616-891-9004
Practice Address - Street 1:6477 CHERRY MEADOW DR SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-7350
Practice Address - Country:US
Practice Address - Phone:616-891-8990
Practice Address - Fax:616-891-9004
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019805122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist