Individual
DR. RYAN KEITH GRAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
115 FARLEY CIR, SUITE 201, LEWISBURG, PA 17837-9252
(570) 768-4455
(866) 668-5729
Mailing address
115 FARLEY CIR, SUITE 201, LEWISBURG, PA 17837-9252
(570) 768-4455
(866) 668-5729
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02342400
NJ
1223E0200X
Endodontics
DN001209
PA
1223E0200X
Endodontics
Primary
DS036179
PA
Other
Enumeration date
05/06/2008
Last updated
09/21/2010
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