| Grace Family Dental | |
|
1538 11th Ave Longview WA 98632-4123 | |
| (323) 804-1324 | |
| Not Available |
| Full Name | Grace Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 1538 11th Ave, Longview, Washington |
| Authorized Official Name and Position | Hamid Azizi (OWNER) |
| Authorized Official Contact | 3238041324 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Family Dental 1538 11th Ave Longview WA 98632-4123 Ph: (323) 804-1324 | Grace Family Dental 1538 11th Ave Longview WA 98632-4123 Ph: (323) 804-1324 |
| NPI Number | 1982325668 |
|---|---|
| Provider Enumeration Date | 09/09/2022 |
| Last Update Date | 09/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982325668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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