Individual
DR. JEREMY GORDON GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
78361 HIGHWAY 25, FOLSOM, LA 70437-3320
(985) 796-9345
Mailing address
78361 HIGHWAY 25, FOLSOM, LA 70437-3320
(985) 796-9345
(985) 796-9345
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6096
LA
Other
Enumeration date
06/26/2008
Last updated
01/02/2019
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