Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 32786 | CA |
NPI | 1003252313 |
---|---|
Provider Name | Grace You |
First Address | Sacramento, CA 95823-2609 |
Second Address | Sacramento, CA 95823-2609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2013 |
Last Update Date | 14/05/2013 |