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Organization
EDITHANN J GRAHAM DMD MS INC
Active
Organization
EDITHANN J GRAHAM DMD MS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITHANN GRAHAM DMD (OWNER)
(619) 226-4784
Entity
Organization
Contact information
Practice address
1806 CABLE ST, SAN DIEGO, CA 92107-3103
(619) 226-4784
(619) 226-3027
Mailing address
1806 CABLE ST, SAN DIEGO, CA 92107-3103
(619) 226-4784
(619) 226-3027
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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