Most Relevant Information
Provider Data
| NPI Number: | 1003343682 |
| Provider Name: | LEANNA GRANDI DA |
| Entity Type: | Individual |
| Taxonomy Code: | 126800000X |
| Specialty: | Dental Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/15/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
10102 NE GLISAN ST
PORTLAND
OR
972204456
Practice Location Phone/Fax
| Phone: | 5032575959 |
| Fax: |
Provider Mailing Location
10102 NE GLISAN ST
PORTLAND
OR
972204456
Provider Mailing Phone/Fax
| Phone: | 5032575959 |
| Fax: |