Elijah Jacob Grayson
NPI #1356917850 in Malmstrom Afb, Montana
Provider Information
- NPI Number
- 1356917850
- Entity Type
- Individual
- Name
- Elijah Jacob Grayson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dental Assistant
- Enumeration Date
- Jun 3, 2021
- Last Updated
- Jun 3, 2021
Practice Location
- Address
- 7300 N PERIMETER RD
- City
- Malmstrom Afb
- State
- Montana
- ZIP Code
- 59402-6701
- Phone
- (406) 731-2511
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Assistant |
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