Individual
GRANT DAVID HARTWELL TIPPET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 JHN PAUL JNS CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2730
Mailing address
3394 VILLAGE SQUARE PL, SUFFOLK, VA 23435-1360
(281) 678-5503
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401418754
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
36667
TX
Other
Enumeration date
04/27/2020
Last updated
07/11/2025
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