Provider Demographics
NPI:1942325089
Name:DENNIS GRABER DDS FAMILY DENTISTRY INC.
Entity Type:Organization
Organization Name:DENNIS GRABER DDS FAMILY DENTISTRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRABER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-339-1369
Mailing Address - Street 1:1729 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2126
Mailing Address - Country:US
Mailing Address - Phone:605-339-1369
Mailing Address - Fax:
Practice Address - Street 1:1729 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2126
Practice Address - Country:US
Practice Address - Phone:605-339-1369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM4961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty