Provider Demographics
NPI:1891944880
Name:GROSSO, FRANK JR (DDS)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:GROSSO
Suffix:JR
Gender:M
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:P.O. BOX 306
Mailing Address - Street 2:11339 LIBERTY RD
Mailing Address - City:LIBERTYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21762
Mailing Address - Country:US
Mailing Address - Phone:301-898-1800
Mailing Address - Fax:301-898-1845
Practice Address - Street 1:11339 LIBERTY RD.
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701
Practice Address - Country:US
Practice Address - Phone:301-898-1800
Practice Address - Fax:301-898-1845
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist