Organization
CONWAYDENTALCORP
Active
Other names
Graphit Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAIVYN MARIE CONWAY DDS (DENTIST)
(619) 475-4226
Entity
Organization
Contact information
Practice address
4190 BONITA RD STE 205, BONITA, CA 91902-1340
(619) 475-4226
Mailing address
4190 BONITA RD STE 205, BONITA, CA 91902-1340
(619) 475-4226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/10/2021
Last updated
09/26/2022
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