Provider Demographics
NPI:1336728237
Name:GRIGG, WILLIAM HARRISON (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HARRISON
Last Name:GRIGG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 WESTOVER TER STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7121
Mailing Address - Country:US
Mailing Address - Phone:336-275-1472
Mailing Address - Fax:
Practice Address - Street 1:1507 WESTOVER TER STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7121
Practice Address - Country:US
Practice Address - Phone:336-275-1472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC126661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice