Jason Scott Grissom D.M.D.

NPI 1699921957 - Dentist - 1223G0001X

NPI Details
NPI 1699921957
Gender Male
Enumeration Date 08/18/2008
Last Updated 08/18/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1896 MAIN ST
SUITE B
MADISON MS, 39110-7676, US
Phone (601) 898-9390
Fax (601) 898-9395
Business Location
1896 MAIN ST
SUITE B
MADISON MS, 39110-7676, US
Phone (601) 898-9390
Fax (601) 898-9395
Toxanomy
Taxonomy Code 1223G0001X
License State Mississippi
License Number 3218-08
Remove 1699921957 NPI Number
 

According to our database, Dr. Jason Scott Grissom D.M.D. NPI is 1699921957, taxonomy code is 1223G0001X and license number is 3218-08, license state is located at Mississippi. Jason Scott Grissom D.M.D. physically located at 1896 Main St, Madison MS, 39110-7676. NPI Number Jason Scott Grissom D.M.D. has the Individual type.

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1699921957 NPI number is provided on an as is basis without warranty of any kind. 1699921957 is maintained by the National Plan & Provider Enumeration System. The contents of Jason Scott Grissom D.M.D. are for informational purposes only.