Individual
KENISHA LASHAE GRANT-HYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6250 ROGERS RD, ROLESVILLE, NC 27571-9357
(919) 562-1520
(919) 562-3296
Mailing address
6250 ROGERS RD, ROLESVILLE, NC 27571-9357
(919) 562-1520
(919) 562-3296
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7982
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901040
—
NC
01
—
9021M
BLUE CROSS BLUE SHIELD NC
—
Enumeration date
08/25/2006
Last updated
01/15/2014
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