Individual
DR. RONALD ALAN GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15081 MACCORKLE AVE, CHELYAN, WV 25035-0040
(304) 595-3551
(304) 595-6822
Mailing address
15081 MACCORKLE AVE, BOX 40, CHELYAN, WV 25035-0040
(304) 595-3551
(304) 595-6822
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2678
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000119839
BLUE CROSS BS
—
05
—
0137007000
—
WV
01
—
119839
UNITED CONCORDIA
—
Enumeration date
02/21/2007
Last updated
01/02/2015
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