Provider Demographics
NPI:1821087925
Name:GRAVEN, WILLIAM LEE JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEE
Last Name:GRAVEN
Suffix:JR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:4122 SHELBYVILLE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3242
Mailing Address - Country:US
Mailing Address - Phone:502-895-8008
Mailing Address - Fax:502-895-8707
Practice Address - Street 1:4122 SHELBYVILLE RD
Practice Address - Street 2:SUITE F
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3242
Practice Address - Country:US
Practice Address - Phone:502-895-8008
Practice Address - Fax:502-895-8707
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
KY4588122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist