| NPI | 1598561847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE LEE Orthodontist/Owner 267-896-1654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-27 |