Provider Demographics
NPI:1285825547
Name:CHEN, GRACE
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LAN
Other - Middle Name:
Other - Last Name:ZHOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7580 E HARVARD AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3767
Mailing Address - Country:US
Mailing Address - Phone:303-752-1339
Mailing Address - Fax:
Practice Address - Street 1:77-6443 KUAKINI HWY
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2227
Practice Address - Country:US
Practice Address - Phone:303-752-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-23081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics