Provider Demographics
NPI:1073625372
Name:GRADY, PAUL FRANCIS (DMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRANCIS
Last Name:GRADY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 N OCEAN DR APT 18A
Mailing Address - Street 2:
Mailing Address - City:SINGER ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33404-2535
Mailing Address - Country:US
Mailing Address - Phone:561-848-9073
Mailing Address - Fax:561-422-8595
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-6576
Practice Address - Fax:561-422-8595
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA131501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice