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General NPI Number Information
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NPI Number | 1427120880
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Entity Type | Organization
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Legal Business Name | JOSEPH A GRIDER DDS PC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 202 N MAIN ST
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City | NEW CASTLE
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State | IN
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Zip | 47362-4211
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Country | US
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Telephone | 765-529-9180
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Fax | 765-529-7442
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Provider Business Mailing Address
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Address Line | 202 N MAIN ST
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City | NEW CASTLE
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State | IN
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Zip | 47362-4211
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Country | US
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Telephone | 765-529-9180
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Fax | 765-529-7442
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH ALLEN GRIDER
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Credential | DDS
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Telephone | 765-529-9180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6498
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License Number State | IN
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