Provider Demographics
NPI:1386344307
Name:GRAEHLER, ADRIANA CAROLINA
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:CAROLINA
Last Name:GRAEHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 S POINT RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-9520
Mailing Address - Country:US
Mailing Address - Phone:704-800-4009
Mailing Address - Fax:
Practice Address - Street 1:965 S POINT RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-9520
Practice Address - Country:US
Practice Address - Phone:704-800-4009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC13870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program