Individual
GRACE CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
10717 CAMINO RUIZ STE 103, SAN DIEGO, CA 92126-2310
(858) 536-1111
Mailing address
3840 ELIJAH CT UNIT 835, SAN DIEGO, CA 92130-6013
(332) 201-7208
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
106152
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/03/2018
Last updated
09/01/2021
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