Provider Demographics
NPI:1659491140
Name:GRILLO, DARIA ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARIA
Middle Name:ANN
Last Name:GRILLO
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 1:128 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2108
Mailing Address - Country:US
Mailing Address - Phone:914-232-5425
Mailing Address - Fax:
Practice Address - Street 1:1 BYRAM BROOK PL
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2319
Practice Address - Country:US
Practice Address - Phone:914-765-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052257122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist