Provider Demographics
NPI:1780726810
Name:GRIMM, STEPHEN EDWARD III (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:GRIMM
Suffix:III
Gender:M
Credentials:DDS
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Mailing Address - Street 1:HOWARD UNIVERSITY COLLEGE OF DENTISTRY
Mailing Address - Street 2:600 W STREET, NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20059-0001
Mailing Address - Country:US
Mailing Address - Phone:202-806-0308
Mailing Address - Fax:202-806-0354
Practice Address - Street 1:HOWARD UNIVERSITY COLLEGE OF DENTISTRY
Practice Address - Street 2:600 W STREET, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-0001
Practice Address - Country:US
Practice Address - Phone:202-806-0308
Practice Address - Fax:202-806-0354
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
DCDEN39221223P0221X
MD78421223P0221X
VA04010062761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry