Organization
GRACE DENTAL STUDIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE HAN DDS (MEMBER)
(718) 578-1126
Entity
Organization
Contact information
Practice address
6741 MYRTLE AVE, GLENDALE, NY 11385-7063
(718) 578-1126
Mailing address
6741 MYRTLE AVE, GLENDALE, NY 11385-7063
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
052066
NY
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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