National Provider Identifier Database

GRAVETTE FAMILY DENTAL
Dental


Contact Information

GRAVETTE FAMILY DENTAL
601 1ST AVE SW
GRAVETTE, AR72736
Phone: 405-930-4100
Fax:
Website:
Specialty Taxonomy Code
* Dental 261QD0000X

* Indicates primary specialty

NPI Profile & details for GRAVETTE FAMILY DENTAL

NPI Number 1417790502
Legal business name
LBN
GRAVETTE FAMILY DENTAL
Authorized official BENJAMIN BOWMAN - (CEO)
Entity Organization
Organization subpart No
Enumeration date 06/17/2024
Last updated 06/17/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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