Individual
MR. GRANT JOSEPH GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3905 61ST ST, WOODSIDE, NY 11377-3566
(718) 577-5069
Mailing address
296 CHERRY DR, PASADENA, CA 91105-2167
(617) 669-9945
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DDS107432
CA
Other
Enumeration date
05/10/2019
Last updated
09/30/2025
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