Provider Demographics
NPI:1720106412
Name:GRIGG, KATHERINE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:A
Last Name:GRIGG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-2728
Mailing Address - Country:US
Mailing Address - Phone:828-765-9002
Mailing Address - Fax:828-765-1614
Practice Address - Street 1:2218 RUTHERFORD RD STE A
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-5368
Practice Address - Country:US
Practice Address - Phone:828-654-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC013T0OtherMARION BCBS GROUP#
NC013CHOtherMORGANTON BCBS GROUP#
NC5900697Medicaid
NC89013T0OtherMARION MEDICAID GROUP#
NC89013CHOtherMORGANTON MEDICAID GROUP#