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NPI 1861473340

NPI 1861473340 : CHRIS GRIFFIN DDS : RIPLEY, MS

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General NPI Number Information
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    NPI Number           |    1861473340
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    Entity Type          |    Individual 
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    Provider Name        |    CHRIS GRIFFIN DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/10/2005
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    415 E WALNUT ST 
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    City                 |    RIPLEY
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    State                |    MS
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    Zip                  |    38663-2113
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    Country              |    US
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    Telephone            |    662-837-8141
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    Fax                  |    662-837-8199
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Provider Business Mailing Address
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    Address Line         |    159 DUMAS RD 
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    City                 |    RIPLEY
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    State                |    MS
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    Zip                  |    38663-9038
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    Country              |    US
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    Telephone            |    662-837-1132
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    Fax                  |    
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    3049-98
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    License Number State |    MS
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