MEDICARE: RONAL DOWNING GRAHAM DDS

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
1	1223G0001X	General Practice Dentistry	7724	GA

General Provider Information

NPI Number	:	1275533598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONAL DOWNING GRAHAM DDS

Provider Business Mailing Address
First Line	:	896 LAFAYETTE ST
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2367
Country	:	US
Telephone Number	:	706-935-2251
Fax Number	:	706-935-5355

Provider Business Practice Location Address
First Line	:	896 LAFAYETTE ST
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2367
Country	:	US
Telephone Number	:	706-935-2251
Fax Number	:	706-935-5355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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