Provider Demographics
NPI:1790385508
Name:GREIF, GRANT CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:CHRISTOPHER
Last Name:GREIF
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 1:935 N DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-2914
Mailing Address - Country:US
Mailing Address - Phone:574-267-3359
Mailing Address - Fax:
Practice Address - Street 1:935 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-2914
Practice Address - Country:US
Practice Address - Phone:574-267-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013486A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice