Individual
CRAIG TODD WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
255 S 17TH ST, #2306, PHILADELPHIA, PA 19103-6231
(215) 732-8080
Mailing address
255 S 17TH ST, #2306, PHILADELPHIA, PA 19103-6231
(215) 732-8080
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS026534L
PA
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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