Healthcare Provider Details

I. General information

NPI: 1669358941
Provider Name (Legal Business Name): GARRIT GRANT ESPLIN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 BOATNER RD BLDG 2751
EGLIN AFB FL
32542-1391
US

IV. Provider business mailing address

340 BOATNER RD BLDG 2751
EGLIN AFB FL
32542-1391
US

V. Phone/Fax

Practice location:
  • Phone: 850-883-8843
  • Fax:
Mailing address:
  • Phone: 850-883-8843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10381989-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: