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NPI Profile for Dr ROGER GRANNUM in BROOKLYN, NY.
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) |
| NPI # | 1003993502 |
|
| Status | Active | |
| Credentials | DDS (Doctor of Dental Surgery) | |
| Entity | Individual | |
| Enumeration date | 11/01/2006 | |
| Last updated | 01/06/2017 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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ROGER GRANNUM
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ROGER GRANNUM, DDS