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General NPI Number Information
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NPI Number | 1588825673
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Entity Type | Organization
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Legal Business Name | RONALD A. GRIFFIN, DDS, LLC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 1140 WESTERN AVE
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-1174
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Country | US
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Telephone | 740-773-8320
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Fax | 740-773-8321
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Provider Business Mailing Address
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Address Line | 1140 WESTERN AVE
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-1174
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Country | US
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Telephone | 740-773-8320
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Fax | 740-773-8321
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. RONALD A GRIFFIN
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Credential | DDS
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Telephone | 740-773-8320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3021161
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License Number State | OH
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