# DR. RONALD A. GRACE, DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grace Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043707334
- **Authorized official:** DR. RONALD A GRACE DDS (DENTIST)
- **Authorized official phone:** (304) 595-3551

## Contact information

- **Practice address:** 15081 MACCORKLE AVE, CHELYAN, WV 25035
- **Practice address phone:** (304) 595-3551
- **Practice address fax:** (304) 595-6822
- **Mailing address:** PO BOX 40, CABIN CREEK, WV 25035-0040
- **Mailing address phone:** (304) 595-3551
- **Mailing address fax:** (304) 595-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2678 | WV | Yes |

## Other

- **Enumeration date:** 04/23/2018
- **Last updated:** 04/23/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0137007000 | — | WV |