Provider Demographics
NPI:1770732695
Name:PINNEY, GRANT S (DMD)
Entity type:Individual
Prefix:DR
First Name:GRANT
Middle Name:S
Last Name:PINNEY
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 1:1325 S INTERNATIONAL PKWY STE 1201
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1406
Mailing Address - Country:US
Mailing Address - Phone:407-862-3344
Mailing Address - Fax:
Practice Address - Street 1:1325 S INTERNATIONAL PKWY STE 1201
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1406
Practice Address - Country:US
Practice Address - Phone:407-862-3344
Practice Address - Fax:407-862-3374
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN182821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice