Timothy T Grantham, DMD

NPI #1063580181 in Valdosta, Georgia

Provider Information

NPI Number: 1063580181
Entity Type: Individual
Name: Timothy T Grantham, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Nov 30, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 103 W CRANFORD AVE
City: Valdosta
State: Georgia
ZIP Code: 31602-2930
Phone: (229) 249-0717

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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