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Individual

DUSTIN R CRAVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
315 E BROMLEY LN, BRIGHTON, CO 80601-3065
(303) 659-1125
Mailing address
315 E BROMLEY LN, BRIGHTON, CO 80601-3065
(303) 659-1125

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN-8853
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15502341
CO
01
1875045
CO MEDICAID
CO
Enumeration date
01/08/2007
Last updated
02/03/2016
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