Individual
KATHLEEN R. CRAIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
6031 MONTICELLO AVE, DALLAS, TX 75206-6126
(214) 826-4963
Mailing address
6031 MONTICELLO AVE, DALLAS, TX 75206-6126
(214) 826-4963
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
16176
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D16176
BCBS PROVIDER #
TX
Enumeration date
08/05/2006
Last updated
03/12/2015
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