Individual
DR. BAILEY HUDSON GRAHAM IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1126 B ST, PETALUMA, CA 94952-4055
(707) 762-7183
(707) 762-4490
Mailing address
1126 B ST, PETALUMA, CA 94952-4055
(707) 762-7183
(707) 762-4490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
53792
CA
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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