Individual
DR. LOUIS S GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5549 S CORNELL AVE, CHICAGO, IL 60637-1914
(773) 684-5702
(773) 684-5493
Mailing address
5549 S CORNELL AVE, CHICAGO, IL 60637-1914
(773) 684-5702
(773) 684-5493
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019018517
IL
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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