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General NPI Number Information
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NPI Number | 1316823438
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Entity Type | Organization
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Legal Business Name | GRACE FAMILY DENTISTRY
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1480 S HARBOR BLVD STE 8
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City | LA HABRA
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State | CA
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Zip | 90631-7567
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Country | US
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Telephone | 714-693-3371
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Fax | 714-526-4671
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Provider Business Mailing Address
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Address Line | 1480 S HARBOR BLVD STE 8
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City | LA HABRA
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State | CA
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Zip | 90631-7567
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Country | US
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Telephone | 714-693-3371
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Fax | 714-526-4671
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Authorized Official
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Title or Position | MANAGER
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Name | NANCY GUERRERO
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Credential |
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Telephone | 714-693-3371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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