Paul Eugene Griner, D.D.S.

Individual provider Active NPI General Practice Dentistry · Windsor, MO

NPI 1831243427 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1831243427
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
013476 (MO)
Practice address
106 E Colt St
Windsor, MO 65360-1806
Phone
(660) 647-3133
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
013476MOMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 013476 MO Yes

Addresses

Primary practice location

106 E Colt St
Windsor, MO 65360-1806

Mailing address

PO Box 89
Windsor, MO 65360-0089
Phone (660) 647-3133

Other identifiers

IdentifierTypeStateIssuer
401501101MedicaidMO

Other providers in Windsor, MO

All providers in Windsor, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.