Anastasia S Graham, CRDH
Dental Hygienist in Beaufort, SC. Individual provider (NPI-1).
NPI number1669122370
StatusActive
Last updated in NPPESMar 25, 2022
Details
- NPI
- 1669122370
- Entity type
- Individual (NPI-1)
- Name
- Anastasia S Graham
- Credential
- CRDH
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2022
- Certification date
- Mar 15, 2022
- Last updated
- Mar 25, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | DH26758 | FL | Yes |
| 124Q00000X | Dental Hygienist | 11388 | SC |
Other names
- Anastasia S Pankratova (Other Name)
Practice location
Mcas Dental, Bldg 598Beaufort, SC 29904
Phone 843-228-7512
Mailing address
Bhc Mcas Dental, Bldg 598Beaufort, SC 29904
Phone 943-228-7512
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