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Individual

CHRISTIAN TIFFANY GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
428 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3040
(203) 503-3187
Mailing address
400 COLUMBUS AVE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3040
(203) 503-3187

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10610
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0051536
CSR
CT
05
008036565
CT
Enumeration date
05/11/2010
Last updated
02/16/2026
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