Individual
DR. STEPHEN DUANE GRAHAM SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1602 SOUTH HOLTZCLAW AVENUE, CHATTANOOGA, TN 37404
(423) 698-5794
Mailing address
P.O. BOX 24475, CHATTANOOGA, TN 37422-4475
(423) 595-1950
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D.S. 4218
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107735
BLUECROSSBLUESHIELD
TN
Enumeration date
05/02/2007
Last updated
07/08/2007
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