Provider Demographics
NPI:1265560957
Name:GRABEMAN, THOMAS ARTHUR
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ARTHUR
Last Name:GRABEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1434
Mailing Address - Country:US
Mailing Address - Phone:937-339-5855
Mailing Address - Fax:937-298-8344
Practice Address - Street 1:4491 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2405
Practice Address - Country:US
Practice Address - Phone:937-298-1353
Practice Address - Fax:937-298-8344
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0165801223G0001X
OH16580122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice