Provider Demographics
NPI:1578572434
Name:GRAVES, CATHY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:LYNN
Last Name:GRAVES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2296
Mailing Address - Country:US
Mailing Address - Phone:513-759-2408
Mailing Address - Fax:
Practice Address - Street 1:6410 THORNBERRY COURT
Practice Address - Street 2:SUITE B
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-759-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH206771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice