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Individual
CHARLES SCOTT GRACE
Active
Individual
CHARLES SCOTT GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3522
ID
Other
Enumeration date
05/07/2007
Last updated
08/02/2010
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