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Individual
RICHARD A CRAIG
Active
Individual
RICHARD A CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019014284
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053431981
GROUP NPI
—
01
—
1063649770
GROUP NPI
—
01
—
1205145554
PRACTICE LOCATION TYPE II NPI
—
01
—
1295165439
PRACTICE LOCATION TYPE II NPI
—
01
—
1306177241
PRACTICE LOCATION TYPE II NPI
—
01
—
1508198474
PRACTICE LOCATION TYPE II NPI
—
01
—
1760882005
PRACTICE LOCATION TYPE II NPI
—
Enumeration date
07/25/2006
Last updated
01/19/2021
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