Individual
DR. LORA D. GRAVES
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-6831
Mailing address
1014 SYCAMORE PL, O FALLON, IL 62269-3723
(618) 624-5520
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2756
WV
Other
Enumeration date
09/19/2005
Last updated
07/08/2007
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