Individual
JOHN ROBERTS GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
50 PLAZA WAY, STE G, MARIETTA, GA 30060
(770) 427-4778
(770) 427-7402
Mailing address
50 PLAZA WAY, STE G, MARIETTA, GA 30060
(770) 427-4778
(770) 427-7402
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
GA8349
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041988
—
GA
Enumeration date
09/05/2006
Last updated
07/08/2007
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