Provider Demographics
NPI:1578847240
Name:JOSEPH N GRIMAUDO DMD PL
Entity Type:Organization
Organization Name:JOSEPH N GRIMAUDO DMD PL
Other - Org Name:ALL SMILES TAMPA BAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:N
Authorized Official - Last Name:GRIMAUDO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-345-8580
Mailing Address - Street 1:17200 CAMELOT CT
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7202
Mailing Address - Country:US
Mailing Address - Phone:813-345-8580
Mailing Address - Fax:813-345-8581
Practice Address - Street 1:17200 CAMELOT CT
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-7202
Practice Address - Country:US
Practice Address - Phone:813-345-8580
Practice Address - Fax:813-345-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty