IndividualActive
Gabriel Grisham
NPI 1720570393 · Oral and Maxillofacial Surgery (Dentist) · Newport, RI
Provider details
- NPI number
- 1720570393
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 0401416112 (VA)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
43 Smith Rd
Newport, RI 02841-1006
Phone: (301) 875-4494
Approximate (ZIP-level) locationGet directions
Mailing address
Psc 475 Box 1935
Fpo, AP 96350-9998
Registry dates
- Enumerated
- 2018-05-30
- Last updated
- 2024-09-12
- Certified
- 2024-09-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.