Provider Demographics
NPI:1528280948
Name:GRABER, STUART (DDS)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:GRABER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 LONG RIDGE RD
Mailing Address - Street 2:UNIT 23
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-1258
Mailing Address - Country:US
Mailing Address - Phone:914-391-5251
Mailing Address - Fax:
Practice Address - Street 1:3505 HILL BLVD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-1283
Practice Address - Country:US
Practice Address - Phone:914-245-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0303241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice