Individual
ROBERT MARK GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
COMMUNITY HEALTH CENTER, 400 TEAGARDEN, LA PORTE, IN 46350-3175
(219) 326-2403
(219) 326-2385
Mailing address
1007 LINCOLNWAY, POST OFFICE BOX 1539, LAPORTE, IN 46350-3201
(219) 326-2403
(219) 326-2385
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
12007607A
IN
Other
Enumeration date
06/07/2006
Last updated
07/08/2007
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