Provider Demographics
NPI:1477243863
Name:CALL, GRACE E (DMD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:E
Last Name:CALL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NEWPORT AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2658
Mailing Address - Country:US
Mailing Address - Phone:708-878-8423
Mailing Address - Fax:
Practice Address - Street 1:105 CONNECTICUT RD
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6117
Practice Address - Country:US
Practice Address - Phone:586-123-9369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN279761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice