Provider Demographics
NPI:1366595621
Name:GRACZA & GRACZA INC
Entity type:Organization
Organization Name:GRACZA & GRACZA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT GRACZA & GRACZA INC
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:REZSO
Authorized Official - Last Name:GRACZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:218-436-2944
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:KARLSTAD
Mailing Address - State:MN
Mailing Address - Zip Code:56732-0223
Mailing Address - Country:US
Mailing Address - Phone:218-436-2944
Mailing Address - Fax:218-436-2947
Practice Address - Street 1:223 S MAIN
Practice Address - Street 2:
Practice Address - City:KARLSTAD
Practice Address - State:MN
Practice Address - Zip Code:56732-0223
Practice Address - Country:US
Practice Address - Phone:218-436-2944
Practice Address - Fax:218-436-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty