Provider Demographics
NPI:1477322493
Name:GRIFFIN SONSTEGARD PLLC
Entity Type:Organization
Organization Name:GRIFFIN SONSTEGARD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRIFFIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SONSTEGARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-876-0824
Mailing Address - Street 1:15610 NE WOODINVILLE DUVALL RD STE 109
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7069
Mailing Address - Country:US
Mailing Address - Phone:425-287-6082
Mailing Address - Fax:425-287-6083
Practice Address - Street 1:15610 NE WOODINVILLE DUVALL RD STE 109
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-7069
Practice Address - Country:US
Practice Address - Phone:425-287-6082
Practice Address - Fax:425-287-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty