Charles Frederick Grannum, MD

NPI #1205904208 in Brooklyn, New York

Provider Information

NPI Number: 1205904208
Entity Type: Individual
Name: Charles Frederick Grannum, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - Prosthodontics
Credential: MD
Enumeration Date: Nov 30, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1536 BEDFORD AVE
City: Brooklyn
State: New York
ZIP Code: 11216-4117
Phone: (800) 376-5566

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Prosthodontics — Prosthodontics	1223P0700X	Primary

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