Provider Demographics
NPI:1063865434
Name:R. CRAIG ENG DDS
Entity Type:Organization
Organization Name:R. CRAIG ENG DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-935-6060
Mailing Address - Street 1:PO BOX 46879
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-0879
Mailing Address - Country:US
Mailing Address - Phone:206-935-6060
Mailing Address - Fax:206-932-7088
Practice Address - Street 1:9639 28TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-4101
Practice Address - Country:US
Practice Address - Phone:206-935-6060
Practice Address - Fax:206-932-7088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00006090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty