Individual
DR. EDITHANN JENNINGS GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
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
1223P0300X
Periodontics
5253
AZ
1223P0300X
Periodontics
Primary
CA56651
CA
Other
Enumeration date
01/04/2006
Last updated
07/17/2009
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