Provider Demographics
NPI:1942511993
Name:EMILY GRAHAM DDS
Entity Type:Organization
Organization Name:EMILY GRAHAM DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHEDULING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-351-2090
Mailing Address - Street 1:21301 KUYKENDAHL RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2611
Mailing Address - Country:US
Mailing Address - Phone:281-351-2090
Mailing Address - Fax:281-516-7950
Practice Address - Street 1:21301 KUYKENDAHL RD
Practice Address - Street 2:SUITE D
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2611
Practice Address - Country:US
Practice Address - Phone:281-351-2090
Practice Address - Fax:281-516-7950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17024122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty