Organization
GRACE DENTAL P.C,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA YUJIN LEE (CO-PRESIDENT)
(847) 650-0260
Entity
Organization
Contact information
Practice address
5437 SWAN CIR, HOFFMAN ESTATES, IL 60192-4618
(847) 650-0260
Mailing address
5437 SWAN CIR, HOFFMAN ESTATES, IL 60192-4618
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-026114
IL
1223G0001X
General Practice Dentistry
019-028193
IL
Other
Enumeration date
12/04/2011
Last updated
12/04/2011
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