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Individual

DR. DE SHAUNDA TAMITA GRAVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
9413 GLENFIELD CT, HOUSTON, TX 77096-3817
(713) 283-5210
(713) 283-5488
Mailing address
9413 GLENFIELD CT, HOUSTON, TX 77096-3817
(713) 283-5210
(713) 283-5488

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19483
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0095630-001
TX
Enumeration date
09/02/2006
Last updated
07/08/2007
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