Provider Demographics
NPI:1396932935
Name:GRAUER, JEANNETTE (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:
Last Name:GRAUER
Suffix:
Gender:F
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 MORRIS AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3309
Mailing Address - Country:US
Mailing Address - Phone:908-688-8111
Mailing Address - Fax:908-964-5666
Practice Address - Street 1:1317 MORRIS AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3309
Practice Address - Country:US
Practice Address - Phone:908-688-8111
Practice Address - Fax:908-964-5666
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0174811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice