Provider Demographics
NPI:1235319344
Name:DY, GRACE NOBLE (DMD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:NOBLE
Last Name:DY
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 1:2755 COUNTRY DR APT 135
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5343
Mailing Address - Country:US
Mailing Address - Phone:510-790-7678
Mailing Address - Fax:
Practice Address - Street 1:807 E KATELLA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-4920
Practice Address - Country:US
Practice Address - Phone:714-282-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA565671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice