Provider Demographics
NPI:1104847367
Name:SIDNEY M. CRAFT, JR., D.D.S., INC.
Entity Type:Organization
Organization Name:SIDNEY M. CRAFT, JR., D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-444-8481
Mailing Address - Street 1:13231 CHAMPION FOREST DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2600
Mailing Address - Country:US
Mailing Address - Phone:281-444-8481
Mailing Address - Fax:
Practice Address - Street 1:13231 CHAMPION FOREST DR
Practice Address - Street 2:SUITE 303
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2600
Practice Address - Country:US
Practice Address - Phone:281-444-8481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty