Provider Demographics
NPI:1588794283
Name:GRACE T. CHU, D.M.D., P.A.
Entity type:Organization
Organization Name:GRACE T. CHU, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-385-8559
Mailing Address - Street 1:6009 BELT LINE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9126
Mailing Address - Country:US
Mailing Address - Phone:972-385-8559
Mailing Address - Fax:972-385-7415
Practice Address - Street 1:6009 BELT LINE RD STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-9126
Practice Address - Country:US
Practice Address - Phone:972-385-8559
Practice Address - Fax:972-385-7415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220151223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty