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General NPI Number Information
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NPI Number | 1871880666
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Entity Type | Individual
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Provider Name | GARRETT GRANT WOOD D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | SCHOFIELD BARRACKS DENTAL CLINIC 315 BRANNON RD BLDG 674
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City | SCHOFIELD BARRACKS
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State | HI
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Zip | 96857
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Country | US
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Telephone | 910-396-7344
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Fax |
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Provider Business Mailing Address
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Address Line | 1 JARRETT WHITE RD
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City | TRIPLER ARMY MEDICAL CENTER
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 315-433-8936
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9717
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 9717
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License Number State | KY
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