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General NPI Number Information
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NPI Number | 1124281084
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Entity Type | Organization
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Legal Business Name | GRANT&JOYNER DDS PA
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 6250 ROGERS RD
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City | ROLESVILLE
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State | NC
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Zip | 27571
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Country | US
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Telephone | 757-339-3279
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Fax | 919-779-6682
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Provider Business Mailing Address
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Address Line | 1005 TURNER MEADOW DR
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City | RALEIGH
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State | NC
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Zip | 27603-7995
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Country | US
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Telephone | 757-339-3279
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Fax | 919-779-6682
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Authorized Official
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Title or Position | VICE PRESIDENT/SECRETARY
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Name | DR. KENISHA LASHAE GRANT
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Credential | DDS
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Telephone | 757-339-3279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7982
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License Number State | NC
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