Provider Demographics
NPI:1609871722
Name:GRINDALL, STEPHEN W (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:W
Last Name:GRINDALL
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 1:8210 NAKETA BEACH WALK
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-3148
Mailing Address - Country:US
Mailing Address - Phone:425-355-3215
Mailing Address - Fax:
Practice Address - Street 1:8210 NAKETA BEACH WALK
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3148
Practice Address - Country:US
Practice Address - Phone:425-355-8866
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4348122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist