Provider Demographics
NPI:1942310768
Name:GRAVER, JOSEPH GREGORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GREGORY
Last Name:GRAVER
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 1:564 OLD YORK ROAD SUITES 2,4
Mailing Address - Street 2:
Mailing Address - City:ETTERS
Mailing Address - State:PA
Mailing Address - Zip Code:17319-9536
Mailing Address - Country:US
Mailing Address - Phone:717-938-1811
Mailing Address - Fax:717-938-1815
Practice Address - Street 1:564 OLD YORK ROAD SUITES 2,4
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-9536
Practice Address - Country:US
Practice Address - Phone:717-938-1811
Practice Address - Fax:717-938-1815
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 035371-L1223D0004X
PADS035371L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No1223G0001XDental ProvidersDentistGeneral Practice