| Grace Dentisry, P.c. | |
|
111 N Country Rd Ste 1 Port Jefferson NY 11777-2605 | |
| (631) 473-4400 | |
| Not Available |
| Full Name | Grace Dentisry, P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 111 N Country Rd Ste 1, Port Jefferson, New York |
| Authorized Official Name and Position | Sara Grace (DENTIST) |
| Authorized Official Contact | 6314734400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Dentisry, P.c. 111 N Country Rd Ste 1 Port Jefferson NY 11777-2605 Ph: (631) 473-4400 | Grace Dentisry, P.c. 111 N Country Rd Ste 1 Port Jefferson NY 11777-2605 Ph: (631) 473-4400 |
| NPI Number | 1356797674 |
|---|---|
| Provider Enumeration Date | 05/05/2016 |
| Last Update Date | 05/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356797674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 053165-1 (New York) | Primary |
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