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Organization
MARK GRAHAM, DDS, INC.
Active
Organization
MARK GRAHAM, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK GRAHAM DDS (DENTIST)
(925) 820-3000
Entity
Organization
Contact information
Practice address
907 SAN RAMON VALLEY BLVD STE 104, DANVILLE, CA 94526-4036
(925) 820-3000
(866) 763-0419
Mailing address
907 SAN RAMON VALLEY BLVD, DANVILLE, CA 94526-4144
(925) 820-3000
(866) 763-0419
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54870
DENTAL LICENSE
CA
Enumeration date
06/28/2022
Last updated
12/29/2024
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