Provider Demographics
NPI:1992200836
Name:DIEHL, GRACE MICHELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:MICHELLE
Last Name:DIEHL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 W 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-4449
Mailing Address - Country:US
Mailing Address - Phone:034-271-9513
Mailing Address - Fax:
Practice Address - Street 1:5150 W 80TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-4449
Practice Address - Country:US
Practice Address - Phone:303-427-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002035811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty