Provider Demographics
NPI:1275533598
Name:GRAHAM, RONAL DOWNING (DDS)
Entity Type:Individual
Prefix:
First Name:RONAL
Middle Name:DOWNING
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:896 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2367
Mailing Address - Country:US
Mailing Address - Phone:706-935-2251
Mailing Address - Fax:706-935-5355
Practice Address - Street 1:896 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2367
Practice Address - Country:US
Practice Address - Phone:706-935-2251
Practice Address - Fax:706-935-5355
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA77241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice