Provider Demographics
NPI:1801058334
Name:GRAU, MICHAEL JAMES JR (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:GRAU
Suffix:JR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:2830 VICTORY PKWY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1785
Mailing Address - Country:US
Mailing Address - Phone:513-245-3072
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:222 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4231
Practice Address - Country:US
Practice Address - Phone:513-475-8783
Practice Address - Fax:513-475-7698
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2020-04-03
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Provider Licenses
StateLicense IDTaxonomies
OH30026049204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery