Provider Demographics
NPI:1427172345
Name:GRAFF & PETERSON DENTAL, LLC
Entity type:Organization
Organization Name:GRAFF & PETERSON DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-249-4917
Mailing Address - Street 1:1809 E PAVILION PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5337
Mailing Address - Country:US
Mailing Address - Phone:970-249-4917
Mailing Address - Fax:
Practice Address - Street 1:1809 E PAVILION PL
Practice Address - Street 2:SUITE A
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5337
Practice Address - Country:US
Practice Address - Phone:970-249-4917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty