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NPI Code Detail

MEDICARE: GRABER FAMILY DENTISTRY

MEDICARE: GRABER FAMILY DENTISTRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center12011289AIN

General Provider Information

NPI Number : 1477786283
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRABER FAMILY DENTISTRY
Provider Business Mailing Address
First Line : PO BOX 604
Second Line :
City : PRINCETON
State : IN
Zip : 47670-0604
Country : US
Telephone Number : 812-386-6150
Fax Number :
Provider Business Practice Location Address
First Line : 901 S MAIN ST
Second Line :
City : PRINCETON
State : IN
Zip : 47670-2653
Country : US
Telephone Number : 812-386-6150
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. DEREK O GRABER
Credential : DDS
Telephone Number : 18123866150
Provider Enumeration Date : 08/26/2009
Last Update Date : 08/26/2009

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Directions to “GRABER FAMILY DENTISTRY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.