Individual
DR. LESLEY ANN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
616 6TH ST, BREMERTON, WA 98337-1420
(360) 377-3776
(360) 373-2096
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
(360) 478-2633
(360) 373-2096
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60098400
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851626592
—
WA
05
—
5060330
—
WA
Enumeration date
10/14/2009
Last updated
04/02/2015
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