Individual
DR. RON L GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1119 WALNUT DR, SUITE 2, ARDMORE, OK 73401-2360
(580) 226-1727
(580) 226-9413
Mailing address
PO BOX 108816, OKLAHOMA CITY, OK 73101-8816
(405) 848-7974
(405) 848-0033
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3389
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100093480A
—
OK
Enumeration date
11/02/2005
Last updated
01/13/2014
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