| NPI | 1013210673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES GREGORY GRAVES Owner 662-562-9484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2275-86) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2010-12-20 |