Individual
MALLORY GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1600 WILSON BLVD STE 620, ARLINGTON, VA 22209-2596
(703) 524-0288
Mailing address
2250 CLARENDON BLVD, APT 1311, ARLINGTON, VA 22201-3332
(518) 588-0198
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414946
VA
Other
Enumeration date
06/10/2014
Last updated
09/01/2015
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