Individual
DR. TIMOTHY GRAYEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
469 S KIRKWOOD RD, KIRKWOOD, MO 63122-6119
(314) 965-6503
(314) 965-7417
Mailing address
469 SOUTH KIRKWOOD ROAD, KIRKWOOD, MO 63122
(314) 965-6503
(314) 965-7417
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2002013144
MO
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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