Individual
GRACE DANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, PHDH
Contact information
Practice address
201 W KENYON RD, CHAMPAIGN, IL 61820-7892
(217) 531-4279
Mailing address
803 E FAIRVIEW DR, TUSCOLA, IL 61953-2002
(217) 531-4279
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.016580
IL
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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