Individual
JOSH GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 ATLANTIC BLVD STE 7, NEPTUNE BEACH, FL 32266-4001
(407) 401-4117
Mailing address
1001 TEMPLE GRV, WINTER PARK, FL 32789-2788
(407) 401-4117
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
28387
FL
390200000X
Student in an Organized Health Care Education/Training Program
2901601892
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
03/21/2023
Last updated
05/13/2026
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