Individual
DR. GRACE JEROME CREECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1749 MASSACHUSETTS AVE, CAMBRIDGE, MA 02140-2217
(617) 491-1161
Mailing address
25 CLARENDON ST STE 1, MALDEN, MA 02148-7613
(617) 909-6048
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1857672
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
06/20/2017
Last updated
09/24/2019
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