Individual
DR. ERIC ALBERT GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
336 E MAIN ST, LIGONIER, PA 15658-1418
(724) 238-6624
(724) 238-6624
Mailing address
336 E MAIN ST, LIGONIER, PA 15658-1418
(724) 238-6624
(724) 238-6624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-018558-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005325110001
—
PA
Enumeration date
07/13/2006
Last updated
07/09/2007
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