| NPI | 1245708866 |
|---|---|
| Doing Business As | ORTHOGRACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOE MEDELLIN Owner 818-280-5596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2018-11-13 |