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Individual
HARLEY BISHOP GRANDIN
Active
Individual
HARLEY BISHOP GRANDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
103151
CA
390200000X
Student in an Organized Health Care Education/Training Program
018002110
IL
Other
Enumeration date
02/27/2017
Last updated
04/07/2022
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