Provider Demographics
NPI:1750395265
Name:GRIFFITH, DEIRDRE JANE (DDS)
Entity type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:JANE
Last Name:GRIFFITH
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 1:334 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043
Mailing Address - Country:US
Mailing Address - Phone:828-245-4194
Mailing Address - Fax:828-245-4825
Practice Address - Street 1:334 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043
Practice Address - Country:US
Practice Address - Phone:828-245-4194
Practice Address - Fax:828-245-4825
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5911122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist