Individual
DR. JARRED AUGUSTUS GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1227 ROCKBRIDGE RD STE 300, STONE MOUNTAIN, GA 30087-3065
(770) 799-0349
Mailing address
4156 KIMLIE CV, DECATUR, GA 30035-1031
(404) 454-1889
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122868
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2022
Last updated
05/16/2023
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