Provider Demographics
NPI:1639478563
Name:B. GRIEVE, LLC
Entity Type:Organization
Organization Name:B. GRIEVE, LLC
Other - Org Name:TINY LITTLE CHOMPERS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRIEVE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-468-7009
Mailing Address - Street 1:4425 S PECOS RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5037
Mailing Address - Country:US
Mailing Address - Phone:702-468-7009
Mailing Address - Fax:
Practice Address - Street 1:4425 S PECOS RD
Practice Address - Street 2:SUITE 2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5037
Practice Address - Country:US
Practice Address - Phone:702-468-7009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty