MEDICARE: DR. JEFFREY C GRABIEL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12169	MI
2	1223G0001X	General Practice Dentistry	012169	MI

General Provider Information

NPI Number	:	1750353264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY C GRABIEL D.D.S.

Provider Business Mailing Address
First Line	:	2425 E LINCOLN ST STE 110
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7122
Country	:	US
Telephone Number	:	248-644-3131
Fax Number	:	248-282-5060

Provider Business Practice Location Address
First Line	:	2425 E LINCOLN ST STE 110
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7122
Country	:	US
Telephone Number	:	248-644-3131
Fax Number	:	248-282-5060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	03/04/2021

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