Individual
JAMES GRAVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
234 S MAIN ST, SLIPPERY ROCK, PA 16057-1247
(267) 939-1435
Mailing address
234 S MAIN ST, SLIPPERY ROCK, PA 16057-1247
(267) 939-1435
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS041141
PA
1223D0004X
Dental Anesthesiology
Primary
DA031831
PA
Other
Enumeration date
02/07/2017
Last updated
07/31/2020
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