Provider Demographics
NPI:1750509972
Name:GRIER, MICHAEL RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RAY
Last Name:GRIER
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:PO BOX 663
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:76050-0663
Mailing Address - Country:US
Mailing Address - Phone:817-866-2065
Mailing Address - Fax:817-866-3133
Practice Address - Street 1:302 DOBBS STREET
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:TX
Practice Address - Zip Code:76050
Practice Address - Country:US
Practice Address - Phone:817-866-2065
Practice Address - Fax:817-866-3133
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX151591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice