Individual
DR. JAMES DEGRACIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
520 N 12TH ST, RICHMOND, VA 23298-5064
(804) 828-9363
Mailing address
PO BOX 7600, MESA, AZ 85216-7600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417441
VA
122300000X
Dentist
102799
CA
Other
Enumeration date
11/06/2018
Last updated
07/28/2021
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