Provider Demographics
NPI:1093446890
Name:CRACIUN, EDWARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:CRACIUN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 DIVISION ST APT 104
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1852
Mailing Address - Country:US
Mailing Address - Phone:239-776-8866
Mailing Address - Fax:
Practice Address - Street 1:819 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3998
Practice Address - Country:US
Practice Address - Phone:262-333-0149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI600101415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist