Provider Demographics
NPI:1427368422
Name:CATHERINE M. GRIGGS,DMD,INC
Entity Type:Organization
Organization Name:CATHERINE M. GRIGGS,DMD,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-345-1136
Mailing Address - Street 1:410 15TH ST E
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-3686
Mailing Address - Country:US
Mailing Address - Phone:205-345-1136
Mailing Address - Fax:
Practice Address - Street 1:410 15TH ST E
Practice Address - Street 2:SUITE B
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-3686
Practice Address - Country:US
Practice Address - Phone:205-345-1136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-09
Last Update Date:2010-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529910060Medicaid
AL90308OtherBLUE CROSS BLUE SHIELD OF AL