Provider Demographics
NPI:1871625160
Name:GRIFFIN DENTAL P. A.
Entity type:Organization
Organization Name:GRIFFIN DENTAL P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:662-837-8141
Mailing Address - Street 1:415 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-2113
Mailing Address - Country:US
Mailing Address - Phone:662-837-8141
Mailing Address - Fax:662-837-8199
Practice Address - Street 1:415 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-2113
Practice Address - Country:US
Practice Address - Phone:662-837-8141
Practice Address - Fax:662-837-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3049-981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty