Individual
DR. JOSHUA THOMAS GRAVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
327 N CEDAR AVE, COOKEVILLE, TN 38501-2420
(931) 528-5105
(931) 528-5118
Mailing address
PO BOX 357, COOKEVILLE, TN 38503-0357
(931) 528-5105
(931) 528-5118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9490
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1531415
—
TN
Enumeration date
06/18/2012
Last updated
06/24/2013
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