Organization
ADRIANE GRAHAM, DDS-A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANE GRAHAM (PRESIDENT)
(310) 742-6088
Entity
Organization
Contact information
Practice address
128 N LOCUST ST, INGLEWOOD, CA 90301
(310) 742-6088
(310) 742-6456
Mailing address
128 N LOCUST ST, INGLEWOOD, CA 90301-1811
(310) 742-6088
(310) 742-6456
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
44404
CA
261QD0000X
Dental Clinic/Center
Primary
44404
CA
Other
Enumeration date
07/18/2013
Last updated
07/31/2018
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