Provider Demographics
NPI:1619956950
Name:GRANDE, PAUL SAVINO (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SAVINO
Last Name:GRANDE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 FIDELITY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-1213
Mailing Address - Country:US
Mailing Address - Phone:216-651-1299
Mailing Address - Fax:
Practice Address - Street 1:7043 PEARL RD
Practice Address - Street 2:210
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-4973
Practice Address - Country:US
Practice Address - Phone:440-845-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist