| Grace Pediatric Dental Care Llc | |
|
2115 Loganville Hwy Ste 101 Grayson GA 30017-1771 | |
| (470) 508-0125 | |
| Not Available |
| Full Name | Grace Pediatric Dental Care Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2115 Loganville Hwy Ste 101, Grayson, Georgia |
| Authorized Official Name and Position | Tabitha Ikpechukwu Efobi (OWNER) |
| Authorized Official Contact | 7578316852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Pediatric Dental Care Llc 2115 Loganville Hwy Ste 101 Grayson GA 30017-1771 Ph: (470) 508-0125 | Grace Pediatric Dental Care Llc 2115 Loganville Hwy Ste 101 Grayson GA 30017-1771 Ph: (470) 508-0125 |
| NPI Number | 1871258913 |
|---|---|
| Provider Enumeration Date | 11/03/2021 |
| Last Update Date | 11/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871258913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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