Provider Demographics
NPI:1376645309
Name:MCGRAW, JOEL KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:KEVIN
Last Name:MCGRAW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:309 CENTRE POINTE DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST. PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376
Mailing Address - Country:US
Mailing Address - Phone:636-441-4415
Mailing Address - Fax:636-441-1704
Practice Address - Street 1:309 CENTRE POINTE DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ST. PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376
Practice Address - Country:US
Practice Address - Phone:636-441-4415
Practice Address - Fax:636-441-1704
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO135421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice