Provider Demographics
NPI:1861473340
Name:GRIFFIN, CHRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:GRIFFIN
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 1:159 DUMAS RD
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-9038
Mailing Address - Country:US
Mailing Address - Phone:662-837-1132
Mailing Address - Fax:
Practice Address - Street 1:415 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-2113
Practice Address - Country:US
Practice Address - Phone:662-837-8141
Practice Address - Fax:662-837-8199
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3049-981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice