GREGORY M. GRAHAM DMDLLC NPI 1073785986

NPI Information

NPI: 1073785986
Provider Name: GREGORY M. GRAHAM, DMD,LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
385 MEADOW RIDGE DRIVE
GREGORY M GRAHAM, DMD, LLC
MILLEDGEVILLE, GA
ZIP 31061
Phone: (478) 452-0270
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GREGORY M. GRAHAM, DMD,LLC is a dental clinic center in Milledgeville, GA. GREGORY M. GRAHAM, DMD,LLC NPI is 1073785986. The provider is registered as an organization entity type.

The provider's business location address is:

385 MEADOW RIDGE DRIVE
GREGORY M GRAHAM, DMD, LLC
MILLEDGEVILLE, GA
ZIP 31061-741
Phone: (478) 452-0270
Fax: (478) 454-1068

The provider's authorized official is Gregory M. Graham .
The authorized official title is Doctor/owner and has the following contact phone number (478) 452-0270.

The enumeration date for this NPI number is 3/31/2008 and was last updated on 7/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	DN010029	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00289341B	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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