DR. Heatherly Henson Grissom, D.M.D.
NPI #1699921965 in Madison, Mississippi
Provider Information
- NPI Number
- 1699921965
- Entity Type
- Individual
- Name
- DR. Heatherly Henson Grissom, D.M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- D.M.D.
- Enumeration Date
- Aug 18, 2008
- Last Updated
- Aug 18, 2008
Practice Location
- Address
- 1896 MAIN ST
- Address 2
- SUITE B
- City
- Madison
- State
- Mississippi
- ZIP Code
- 39110-7676
- Phone
- (601) 898-9390
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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