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Dr. Thomas Grandville, DDS
Pediatric Dentist in Port Jefferson Station, New York
NPI 1487949236

Thomas Grandville is a Pediatric Dentist based in Port Jefferson Station, NY and is specialized in Pediatric Dentistry. Thomas Grandville practices in Port Jefferson Station, NY and has the professional credentials of DDS. The NPI Number for Thomas Grandville is 1487949236 and holds a License No. 056816 (New York).

The current practice location address for Thomas Grandville is 8 Medical Dr, Port Jefferson Station, NY and can be reached out via phone at 631-928-8585.

Location: 8 Medical Dr, Port Jefferson Station, NY, 11776-1601
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487949236
Provider Name
Thomas Grandville
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
8 Medical Dr, Port Jefferson Station, NY, 11776-1601
Phone Number
631-928-8585
Fax Number
Provider Enumeration Date
06/09/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
8 Medical Dr
City
Port Jefferson Station
State
New York
Zip
11776-1601
Phone Number
631-928-8585
Fax Number
person
Provider Business Mailing Address Details
Address
8 Medical Dr
City
Port Jefferson Station
State
New York
Zip
11776-1601
Phone Number
631-928-8585
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
056816 (New York)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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