Grannum, Charles Frederick

Grannum, Charles Frederick is an individual health care provider with primary practice located at 1536 Bedford Ave , Brooklyn NY 11216-4117. He recently has only one registered license in Dental Providers / Prosthodontics, which is considered as his primary health care specialty. Grannum, Charles Frederick can be contacted via phone (800) 376-5566.

Contact Information

Primary practice address
1536 Bedford Ave Brooklyn NY 11216-4117
Phone: (800) 376-5566
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Prosthodontics 1223P0700X 040024 New York

Profile Details

NPI number 1205904208
LBN Legal business name Grannum, Charles Frederick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205904208 NPPES
New York Other 040024 LICENSE

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