Individual
DR. LARRY LLOYD GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1050 WISHARD BLVD, RM. 4201, INDIANAPOLIS, IN 46202-2872
(317) 274-5315
Mailing address
1050 WISHARD BLVD, RM. 4201, INDIANAPOLIS, IN 46202-2872
(317) 274-5315
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12006195A
IN
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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