Individual
DR. DOUGLAS M GRAYDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
107 GORDON ST, CHICKAMAUGA, GA 30707-1454
(706) 375-3621
(706) 375-8054
Mailing address
PO BOX 369, CHICKAMAUGA, GA 30707-0369
(706) 375-3621
(706) 375-8054
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8054
GA
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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