Ann Marie Grady
Oral & Maxillofacial Surgeon
1313 E Herndon Ave 104
Fresno
, California 93720-3306
Ann Marie Grady
Oral & Maxillofacial Surgeon
1313 E Herndon Ave 104
Fresno
, California 93720-3306
(559) 435-7935
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Ann Marie Grady
- 1313 E Herndon Ave 104
- Fresno, CA
- Zip : 93720-3306
- Fax : (559) 435-7935
- Phone : (559) 435-7993
Second Address
- Ann Marie Grady
- 1313 E Herndon Ave 104
- Fresno, CA
- Zip : 93720-3306
- Fax : (559) 435-7935
- Phone : (559) 435-7993
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 53741 | CA |
National Provider Identifier
| NPI | 1306920970 |
|---|---|
| Provider Name | Ann Marie Grady |
| First Address | Fresno, CA 93720-3306 |
| Second Address | Fresno, CA 93720-3306 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 53741 | D.D.S. (01) | CA |
| BG7743633 | DEA CERTIFICATE (01) | CA |
| DS0537410 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.