Healthcare Provider Details

I. General information

NPI: 1265357644
Provider Name (Legal Business Name): CHRISTINA TAYLOR GRACE DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 BROAD ST
CLIFTON NJ
07013-3346
US

IV. Provider business mailing address

61 BATTA LN
ROSELAND NJ
07068-2200
US

V. Phone/Fax

Practice location:
  • Phone: 973-338-1383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI03137000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: