Organization
FULL SMILE PERIODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM E GRAVES DMD (OWNER)
(806) 353-1055
Entity
Organization
Contact information
Practice address
4515 VAN WINKLE DR, AMARILLO, TX 79119-6423
(806) 699-6111
(806) 353-7077
Mailing address
5051 S SONCY RD, AMARILLO, TX 79119-6667
(806) 353-1055
(806) 353-7077
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
06/03/2022
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