Organization
DR. RONALD A. GRACE, DDS PLLC
Active
Other names
Grace Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD A GRACE DDS (DENTIST)
(304) 595-3551
Entity
Organization
Contact information
Practice address
15081 MACCORKLE AVE, CHELYAN, WV 25035
(304) 595-3551
(304) 595-6822
Mailing address
PO BOX 40, CABIN CREEK, WV 25035-0040
(304) 595-3551
(304) 595-6822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2678
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137007000
—
WV
Enumeration date
04/23/2018
Last updated
04/23/2018
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