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General NPI Number Information
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NPI Number | 1598496598
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Entity Type | Individual
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Provider Name | WILLIAM CARTER GRINE DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 1602 BENJAMIN PKWY STE A
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City | GREENSBORO
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State | NC
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Zip | 27408-2016
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Country | US
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Telephone | 336-288-0010
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Fax | 336-282-5754
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Provider Business Mailing Address
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Address Line | 1602 BENJAMIN PKWY STE A
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City | GREENSBORO
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State | NC
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Zip | 27408-2016
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Country | US
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Telephone | 336-288-0010
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Fax | 336-282-5754
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 30.026914
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12753
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License Number State | NC
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