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NPI Code Detail

MEDICARE: LOWELL RICHARD GRAVES DDS

MEDICARE:   LOWELL RICHARD GRAVES  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
11223E0200XEndodontics3316CO

General Provider Information

NPI Number : 1821022872
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOWELL RICHARD GRAVES DDS
Provider Business Mailing Address
First Line : PO BOX 23167
Second Line :
City : SILVERTHORNE
State : CO
Zip : 80498-3167
Country : US
Telephone Number : 970-262-0800
Fax Number :
Provider Business Practice Location Address
First Line : 3190 S WADSWORTH BLVD
Second Line : SUITE 300
City : LAKEWOOD
State : CO
Zip : 80227-4899
Country : US
Telephone Number : 303-988-6110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 07/08/2007

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Directions to “ LOWELL RICHARD GRAVES DDS” Practice Location

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