All Medicaid billing entities listing GRANDY, STEPHEN (PRESIDENT) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Wyoming | 1 | $416.00 |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | DIAMOND G DENTAL LLC | KEMMERER, WY | General Practice Dentistry | $416.00 |