Provider Demographics
NPI:1881665834
Name:GRIPPO, DONALD ROSS (DDS)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:ROSS
Last Name:GRIPPO
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 1:10 HIGGINS HWY
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1437
Mailing Address - Country:US
Mailing Address - Phone:860-423-2587
Mailing Address - Fax:
Practice Address - Street 1:10 HIGGINS HWY
Practice Address - Street 2:SUITE 10
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1437
Practice Address - Country:US
Practice Address - Phone:860-423-2587
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT44161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery