Individual
DR. JAY DOUGLAS GRAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 WILFORD HALL LOOP, BLDG 4554, ATTN: 59 MDW/SGHC, POC: MS DARLON JACKSON, JBSA-LACKLAND, TX 78256-9908
(210) 292-6225
Mailing address
1100 WILFORD HALL LOOP, BLDG 4554, ATTN: 59 MDW/SGHC, POC: MS DARLON JACKSON, JBSA-LACKLAND, TX 78236-9908
(210) 292-6552
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DS025182L
PA
Other
Enumeration date
12/19/2005
Last updated
08/05/2019
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