Healthcare Provider Details

I. General information

NPI: 1821106972
Provider Name (Legal Business Name): FRANK PAUL GROSSO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 SLEEPY HOLLOW RD SUITE 2G
FALLS CHURCH VA
22044-2003
US

IV. Provider business mailing address

2946 SLEEPY HOLLOW RD SUITE 2G
FALLS CHURCH VA
22044-2003
US

V. Phone/Fax

Practice location:
  • Phone: 703-532-0072
  • Fax:
Mailing address:
  • Phone: 703-532-0072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401003354
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: