Provider Demographics
NPI:1922202423
Name:GRIFFIN, ALFRED C JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:C
Last Name:GRIFFIN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:179 BROADVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2401
Mailing Address - Country:US
Mailing Address - Phone:540-347-1888
Mailing Address - Fax:540-347-7236
Practice Address - Street 1:179 BROADVIEW AVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2401
Practice Address - Country:US
Practice Address - Phone:540-347-1888
Practice Address - Fax:540-347-7236
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA59371223X0400X
VA04010059371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics