Individual
ELAINA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
9071 CENTER ST, MANASSAS, VA 20110-5430
(703) 609-1182
Mailing address
9071 CENTER ST, MANASSAS, VA 20110-5430
(703) 609-1182
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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