Grace Dental Image Center

NPI #1902158397 in La Habra, California

Provider Information

NPI Number: 1902158397
Entity Type: Organization
Organization Name: Grace Dental Image Center
Primary Specialty: Dentist
Enumeration Date: Oct 9, 2012
Last Updated: Oct 9, 2012

Practice Location

Address: 1210 S EUCLID ST
City: La Habra
State: California
ZIP Code: 90631-7306
Phone: (714) 871-4962

Authorized Official

Name: HELENA LEE
Title: OFFICE MANAGER
Phone: (714) 871-4962

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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