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DR. GRANT R HARTUP DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1447251574

Individual Registrant:
DR. GRANT R HARTUP DDS
Gender: M

Location and contact information for practice:
HQ USAF/SGCD 110 LUKE AVE, ROOM 400 BOLLING AFB, DC 20032 US
Tel: 202-767-4385  Fax: --

Contact information for business:
8092 PAPER BIRCH DR  LORTON, VA 22079-5654 US
Tel: 703-495-9150  Fax: --

Registration Information:
NPI: 1447251574
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
MND9740

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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