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General NPI Number Information
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NPI Number | 1659602043
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Entity Type | Organization
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Legal Business Name | LD MCGRAW, DDS, PLLC
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 1010 W CENTER ST
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City | BEEBE
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State | AR
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Zip | 72012-3165
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Country | US
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Telephone | 501-882-3540
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Fax | 501-882-0535
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Provider Business Mailing Address
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Address Line | 501 BRANDON DR
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City | BEEBE
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State | AR
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Zip | 72012-3837
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Country | US
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Telephone | 501-882-3540
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Fax | 501-882-0535
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LARRY D MCGRAW
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Credential | DDS
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Telephone | 501-882-3540
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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 | 3021
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License Number State | AR
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