Provider Demographics
NPI:1942229133
Name:DRS. GRIMM AND SAWYER, FAMILY DENTAL PRACTICE, LLC
Entity Type:Organization
Organization Name:DRS. GRIMM AND SAWYER, FAMILY DENTAL PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GRIMM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-266-6366
Mailing Address - Street 1:132 HOLIDAY CT
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7005
Mailing Address - Country:US
Mailing Address - Phone:410-266-6366
Mailing Address - Fax:410-266-6366
Practice Address - Street 1:132 HOLIDAY CT
Practice Address - Street 2:SUITE 202
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7005
Practice Address - Country:US
Practice Address - Phone:410-266-6366
Practice Address - Fax:410-266-6366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty