Organization
GRACE DENTISRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARA GRACE DDS (DENTIST)
(631) 473-4400
Entity
Organization
Contact information
Practice address
111 N COUNTRY RD STE 1, PORT JEFFERSON, NY 11777-2605
(631) 473-4400
Mailing address
111 N COUNTRY RD STE 1, PORT JEFFERSON, NY 11777-2605
(631) 473-4400
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
053165-1
NY
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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