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Individual

DR. JONELLE SENITA GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4837 BENNING RD SE, WASHINGTON, DC 20019-6145
(202) 650-5238
Mailing address
100 I ST SE APT 1117, WASHINGTON, DC 20003-4873
(919) 641-2676

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8228
NC
1223P0221X
Pediatric Dentistry
DEN1000885
DC

Other

Enumeration date
11/08/2006
Last updated
08/09/2012
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