Provider Demographics
NPI:1528192499
Name:GRATTAFIORI, DAVID ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLEN
Last Name:GRATTAFIORI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PRESTON RD STE 310
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3603
Mailing Address - Country:US
Mailing Address - Phone:972-612-9970
Mailing Address - Fax:972-758-0141
Practice Address - Street 1:1400 PRESTON RD STE 310
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3603
Practice Address - Country:US
Practice Address - Phone:972-612-9970
Practice Address - Fax:972-758-0141
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14054OtherDENTAL LICENSE