Individual
URSULA LANETTE GRANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
216 BARNETBY WAY, COLUMBIA, SC 29229-9599
(757) 310-1329
Mailing address
4611 HARD SCRABBLE RD, SUITE#109-232, COLUMBIA, SC 29229-8584
(803) 262-3178
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3592 IA3389
SC
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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