Robert Mark Grace
Dental Public Health
Community Health Center 400 Teagarden
La Porte
, Indiana 46350-3175
Robert Mark Grace
Dental Public Health
Community Health Center 400 Teagarden
La Porte
, Indiana 46350-3175
(219) 326-2385
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About
Features
Specialties
- Dental Public Health
Languages spoken
- English
Location
First Address
- Robert Mark Grace
- 1007 Lincolnway Post Office Box 1539
- Laporte, IN
- Zip : 46350-3201
- Fax : (219) 326-2385
- Phone : (219) 326-2403
Second Address
- Robert Mark Grace
- Community Health Center 400 Teagarden
- La Porte, IN
- Zip : 46350-3175
- Fax : (219) 326-2385
- Phone : (219) 326-2403
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223D0001X | Dental Public Health | 12007607A | IN |
National Provider Identifier
| NPI | 1710927843 |
|---|---|
| Provider Name | Robert Mark Grace |
| First Address | Laporte, IN 46350-3201 |
| Second Address | La Porte, IN 46350-3175 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| V07059 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.