| Grandridge Dental | |
|
7103 W Grandridge Blvd Ste G Kennewick WA 99336-6713 | |
| (509) 737-1800 | |
| (509) 734-9448 |
| Full Name | Grandridge Dental |
|---|---|
| Speciality | Dentist |
| Location | 7103 W Grandridge Blvd Ste G, Kennewick, Washington |
| Authorized Official Name and Position | Jeffrey Morgan (OWNER) |
| Authorized Official Contact | 5097371800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grandridge Dental 7103 W Grandridge Blvd Ste G Kennewick WA 99336-6713 Ph: () - | Grandridge Dental 7103 W Grandridge Blvd Ste G Kennewick WA 99336-6713 Ph: (509) 737-1800 |
| NPI Number | 1255886487 |
|---|---|
| Provider Enumeration Date | 08/17/2016 |
| Last Update Date | 09/30/2022 |
| Medicare PECOS PAC ID | 1153797170 |
|---|---|
| Medicare Enrollment ID | O20221017001952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255886487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Jeffrey D Morgan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275606543 PECOS PAC ID: 3971979998 Enrollment ID: I20221017002137 |
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