Individual
DR. GREGORY RUSSELL CHACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4479 N HARBOR CITY BLVD, SUITE 5, MELBOURNE, FL 32935-4800
(321) 242-3300
(321) 242-9393
Mailing address
4479 N HARBOR CITY BLVD, MELBOURNE, FL 32935-4800
(321) 242-3300
(321) 242-9393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17650
FL
Other
Enumeration date
07/21/2006
Last updated
10/27/2016
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