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1710927843
ROBERT MARK GRACE
LA PORTE, IN
NPI
1710927843
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223D0001X Dentist, Dental Public Health
(Licence: IN 12007607A)
Enumeration Date
2006-06-07
Last Update Date
2007-07-08
Business Address
-- ROBERT MARK GRACE DDS
COMMUNITY HEALTH CENTER 400 TEAGARDEN
LA PORTE, IN 46350-3175
Phone number: 219-326-2403
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Mailing Address
-- ROBERT MARK GRACE DDS
1007 LINCOLNWAY POST OFFICE BOX 1539
LAPORTE, IN 46350-3201
Phone number: 219-326-2403
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