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General NPI Number Information
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NPI Number | 1760378871
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Entity Type | Organization
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Legal Business Name | GRANT FAMILY DENTISTRY
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 225 EAGLE CREST DR
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City | RANGELY
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State | CO
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Zip | 81648-3105
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Country | US
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Telephone | 970-272-1712
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Fax | 970-272-1726
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Provider Business Mailing Address
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Address Line | 225 EAGLE CREST DR
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City | RANGELY
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State | CO
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Zip | 81648-3105
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Country | US
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Telephone | 970-272-1712
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Fax | 970-272-1726
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Authorized Official
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Title or Position | OWNER
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Name | TREVOR GRANT
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Credential | DDS
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Telephone | 719-201-7026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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