Individual
DR. RANDALL K GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9006 E 62ND ST, SUITE A, TULSA, OK 74133-6371
(918) 249-0249
(918) 249-1055
Mailing address
9006 E 62ND ST, SUITE A, TULSA, OK 74133-6371
(918) 249-0249
(918) 249-1055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3842
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731275745001
BCBS
OK
Enumeration date
08/30/2005
Last updated
07/09/2007
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