Doctor Name: | DR. JAY DOUGLAS GRAVER |
NPI Number: | 1356327639 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DMD |
License Number: | DS025182L |
Business Practice Address: | 238 Brookley Ave 579 Medical Group/credentials Bolling Afb, DC - 200323482 |
Business Phone Number: | 2027675668 |
Business Fax Number: | |
Mailing Address: | 10908 Rippon Lodge Dr, FAIRFAX |
State: | VA |
Postal Code: | 220322932 |
Phone Number: | 7032780313 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0700X |
License Number: | DS025182L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Prosthodontics |
Taxonomy Definition: | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |