Healthcare Provider Details
I. General information
NPI: 1699639773
Provider Name (Legal Business Name): DAVID M GRAHAM DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
406 3RD AVE NE
CULLMAN AL
35055-2928
US
IV. Provider business mailing address
406 3RD AVE NE
CULLMAN AL
35055-2928
US
V. Phone/Fax
- Phone: 256-739-6418
- Fax:
- Phone: 256-739-6418
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
MATTHEW
GRAHAM
Title or Position: OWNER
Credential: DMD
Phone: 256-347-0152