Individual
DR. ELISE BURTON GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4301 LINCOLN RD, SUITE 10, HATTIESBURG, MS 39402-3036
(601) 582-2578
Mailing address
4301 LINCOLN RD, SUITE 10, HATTIESBURG, MS 39402-3036
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3656-12
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/05/2012
Last updated
01/28/2016
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