Individual
CHARLES A CRAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
4344 20TH AVE S, SUITE 2, FARGO, ND 58103-7436
(701) 239-5969
(701) 239-0034
Mailing address
4344 20TH AVE S, SUITE 2, FARGO, ND 58103-7436
(701) 239-5969
(701) 239-0034
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1927
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1927
DENTAL LICENSE
ND
05
—
41302
—
ND
Enumeration date
11/06/2006
Last updated
12/14/2010
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