Provider Demographics
NPI:1174827521
Name:GRANIZO, HUBERT J (DDS)
Entity type:Individual
Prefix:
First Name:HUBERT
Middle Name:J
Last Name:GRANIZO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 N CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1906
Mailing Address - Country:US
Mailing Address - Phone:408-937-9555
Mailing Address - Fax:408-937-9558
Practice Address - Street 1:379 N CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1906
Practice Address - Country:US
Practice Address - Phone:408-937-9555
Practice Address - Fax:408-937-9558
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice