Healthcare Provider Details

I. General information

NPI: 1003385790
Provider Name (Legal Business Name): KIMBERLY L GRAGG DDS MS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 S GREEN ST STE 201
MORGANTON NC
28655-3897
US

IV. Provider business mailing address

509 HARPER AVE SW
LENOIR NC
28645-5076
US

V. Phone/Fax

Practice location:
  • Phone: 828-438-8998
  • Fax: 828-438-8898
Mailing address:
  • Phone: 828-438-8998
  • Fax: 828-438-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KIMBERLY LUTZ GRAGG
Title or Position: OWNER
Credential: DDS, MS, PLLC
Phone: 828-438-8998