Provider Demographics
NPI:1477299253
Name:KEVIN GRILL DDS, LLC
Entity type:Organization
Organization Name:KEVIN GRILL DDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:BRENNAN
Authorized Official - Last Name:GRILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-827-5184
Mailing Address - Street 1:6446 NEWGRANGE DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8210
Mailing Address - Country:US
Mailing Address - Phone:614-827-5184
Mailing Address - Fax:
Practice Address - Street 1:7421 STATE ROUTE 366
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43324-9670
Practice Address - Country:US
Practice Address - Phone:937-843-3932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-05
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental