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Individual

THEODORE GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
626 SECOND AVENUE, OKANOGAN, WA 98840-9679
(509) 422-5700
(509) 422-7680
Mailing address
PO BOX 1340, OKANOGAN, WA 98840-1340
(509) 422-5700
(509) 422-7680

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60432317
WA

Other

Enumeration date
02/20/2014
Last updated
02/20/2014
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