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Individual
GRANT ROSS
Active
Individual
GRANT ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D.0006775-C1
AL
122300000X
Dentist
DN24882
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/26/2019
Last updated
06/16/2020
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