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General NPI Number Information
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NPI Number | 1588794283
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Entity Type | Organization
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Legal Business Name | GRACE T. CHU, D.M.D., P.A.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 6009 BELT LINE RD STE 140
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City | DALLAS
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State | TX
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Zip | 75254-9126
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Country | US
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Telephone | 972-385-8559
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Fax | 972-385-7415
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Provider Business Mailing Address
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Address Line | 6009 BELT LINE RD STE 140
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City | DALLAS
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State | TX
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Zip | 75254-9126
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Country | US
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Telephone | 972-385-8559
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Fax | 972-385-7415
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GRACE TAN CHU
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Credential | D.M.D.
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Telephone | 972-385-8559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 22015
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License Number State | TX
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