Brently Allan Grimard in Pueblo - Periodontics
Brently Allan Grimard - NPI 1093999179
Brently Allan Grimard is a Periodontics in Pueblo, Colorado. Brently Allan Grimard practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Brently Allan Grimard is 1093999179. The last update date is 2008-12-02.
Brently Allan Grimard's current location address is 3903 Outlook Blvd, Pueblo, Colorado. You can contact this provider via phone number 7195456485 and fax number 7195456486. The mailing address for Brently Allan Grimard is 3903 Outlook Blvd, Pueblo, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brently Allan Grimard |
|---|---|
| Address | 3903 Outlook Blvd, Pueblo, Colorado |
| Phone Number | 7195456485 |
| Fax Number | 7195456486 |
| Sole Proprietor | Y |
| Credentials | D.D.S., M. |
NPI Number Detail
| NPI Number | 1093999179 |
|---|---|
| Provider Enumeration Date | 2007-12-24 |
| Last Updated Date | 2008-12-02 |
Provider Mailing Address Detail
| Address | 3903 Outlook Blvd |
|---|---|
| City | Pueblo |
| State | Colorado (CO) |
| Post Code | 810081624 |
| Phone Number | 7195456485 |
| Fax Number | 7195456486 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 8681 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Brently Allan Grimard by the Centers for Medicare & Medicaid Services?
The Brently Allan Grimard has been issued the NPI (National Provider Identifier) 1093999179, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Brently Allan Grimard?
The Brently Allan Grimard is physically situated at 3903 Outlook Blvd, in the city of Pueblo, state of CO, with the postal code 810081624.
What is Brently Allan Grimard's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Brently Allan Grimard is Periodontics, and the corresponding taxonomy classification code for this specialized field is 1223P0300X.
On what date did the Centers for Medicare & Medicaid Services issue the 1093999179 to Brently Allan Grimard?
The Brently Allan Grimard received its 1093999179 assignment from the Centers for Medicare & Medicaid Services on 2007-12-24.
As of what date were the details pertaining to Brently Allan Grimard last refreshed?
The information related to the Brently Allan Grimard, including its address, specialty, and other relevant details, was last updated on 2008-12-02.
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