Provider Demographics
NPI:1013080522
Name:GRIO, GILBERT J (DDS)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:J
Last Name:GRIO
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 1:110 THICKET LN
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:CA
Mailing Address - Zip Code:95019-3125
Mailing Address - Country:US
Mailing Address - Phone:831-722-3908
Mailing Address - Fax:831-722-2311
Practice Address - Street 1:110 THICKET LN
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:CA
Practice Address - Zip Code:95019-3125
Practice Address - Country:US
Practice Address - Phone:831-722-3908
Practice Address - Fax:831-722-2311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice