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General NPI Number Information
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NPI Number | 1881832509
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Entity Type | Organization
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Legal Business Name | CRANIO MANDIBULAR AFFILIATES
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 4214 ANDREWS HWY STE-307
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City | MIDLAND
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State | TX
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Zip | 79703-4822
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Country | US
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Telephone | 432-522-3546
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Fax | 432-522-1882
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Provider Business Mailing Address
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Address Line | 4214 ANDREWS HWY STE-307
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City | MIDLAND
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State | TX
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Zip | 79703-4822
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Country | US
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Telephone | 432-522-3546
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Fax | 432-522-1882
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Authorized Official
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Title or Position | OWNER
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Name | DR. GRANT E GILES
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Credential | DDS
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Telephone | 432-522-3546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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