Provider Demographics
NPI:1487286001
Name:GRAF FAMILY DENTAL LLC
Entity type:Organization
Organization Name:GRAF FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-464-8001
Mailing Address - Street 1:8714 TENNYSON AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-1932
Mailing Address - Country:US
Mailing Address - Phone:740-464-8001
Mailing Address - Fax:
Practice Address - Street 1:8714 TENNYSON AVE
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-1932
Practice Address - Country:US
Practice Address - Phone:740-464-8001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty