Provider Demographics
NPI:1790660892
Name:GRIMES, CONNOR (DDS)
Entity type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:
Last Name:GRIMES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 RIVERA CIRCLE
Mailing Address - Street 2:APT 101
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:780-288-2659
Mailing Address - Fax:
Practice Address - Street 1:3126 RIVERA CIRCLE
Practice Address - Street 2:APT 101
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108
Practice Address - Country:US
Practice Address - Phone:780-288-2659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program