Provider Demographics
NPI:1437147741
Name:GRAVES, ALAN CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:CRAIG
Last Name:GRAVES
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 1:9704 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LANHAM SEABROOK
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2306
Mailing Address - Country:US
Mailing Address - Phone:301-563-6068
Mailing Address - Fax:301-563-6069
Practice Address - Street 1:700 SLIGO AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4794
Practice Address - Country:US
Practice Address - Phone:301-563-6068
Practice Address - Fax:301-563-6069
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD117061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice