Provider Demographics
NPI:1225375041
Name:GROSSMAN, JANICE K (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:K
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7811 MONTROSE ROAD SUITE 300
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:301-530-3717
Mailing Address - Fax:301-417-8170
Practice Address - Street 1:7811 MONTROSE ROAD SUITE 300
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854
Practice Address - Country:US
Practice Address - Phone:301-530-3717
Practice Address - Fax:301-417-8170
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD89-05122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist