Organization
GRACE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE LEE DMD (OWNER)
(931) 648-4100
Entity
Organization
Contact information
Practice address
304 PROVIDENCE BLVD, CLARKSVILLE, TN 37042
(931) 648-4100
(931) 648-4988
Mailing address
304 PROVIDENCE BLVD, CLARKSVILLE, TN 37042-4326
(931) 648-4100
(931) 648-4988
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q037677
—
TN
Enumeration date
06/14/2017
Last updated
07/21/2022
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