Dr. Brently Allan Grimard
Periodontist
3903 Outlook Blvd
Pueblo
, Colorado 81008-1624
Dr. Brently Allan Grimard
Periodontist
3903 Outlook Blvd
Pueblo
, Colorado 81008-1624
(719) 545-6486
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Brently Allan Grimard
- 3903 Outlook Blvd
- Pueblo, CO
- Zip : 81008-1624
- Fax : (719) 545-6486
- Phone : (719) 545-6485
Second Address
- Dr. Brently Allan Grimard
- 3903 Outlook Blvd
- Pueblo, CO
- Zip : 81008-1624
- Fax : (719) 545-6486
- Phone : (719) 545-6485
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 8681 | CO |
National Provider Identifier
| NPI | 1093999179 |
|---|---|
| Provider Name | Dr. Brently Allan Grimard |
| First Address | Pueblo, CO 81008-1624 |
| Second Address | Pueblo, CO 81008-1624 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/12/2007 |
| Last Update Date | 02/12/2008 |
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.