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General NPI Number Information
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NPI Number | 1649527508
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Entity Type | Individual
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Provider Name | MEGAN JENIFER GRAFF D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2012
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 221 3RD ST W
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City | JBSA RANDOLPH
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State | TX
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Zip | 78150-4800
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Country | US
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Telephone | 210-652-8522
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Fax |
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Provider Business Mailing Address
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Address Line | 6112 CANYON RIM DR
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City | ROCKLIN
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State | CA
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Zip | 95765-4203
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Country | US
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Telephone | 530-515-2727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61431
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DDS61431
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License Number State | CA
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