Individual
DR. GRANT R HARTUP
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
HQ USAF/SGCD, 110 LUKE AVE, ROOM 400, BOLLING AFB, DC 20032
(202) 767-4385
Mailing address
8092 PAPER BIRCH DR, LORTON, VA 22079-5654
(703) 495-9150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9740
MN
Other
Enumeration date
08/10/2005
Last updated
07/08/2007
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