| Matthew D Grace Dds, Pllc | |
|
5621 S Broadway Ave Tyler TX 75703-4348 | |
| (903) 630-6313 | |
| Not Available |
| Full Name | Matthew D Grace Dds, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5621 S Broadway Ave, Tyler, Texas |
| Authorized Official Name and Position | Matthew D Grace (DENTIST) |
| Authorized Official Contact | 9033169419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew D Grace Dds, Pllc 353 Vzcr 1519 Grand Saline TX 75140-5744 Ph: () - | Matthew D Grace Dds, Pllc 5621 S Broadway Ave Tyler TX 75703-4348 Ph: (903) 630-6313 |
| NPI Number | 1104397868 |
|---|---|
| Provider Enumeration Date | 12/06/2018 |
| Last Update Date | 12/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104397868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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