Provider Demographics
NPI:1144244864
Name:MCBETH, CRAIG F (DMD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:F
Last Name:MCBETH
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 1:527 HURRICANE RD
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2162
Mailing Address - Country:US
Mailing Address - Phone:603-352-8534
Mailing Address - Fax:603-355-1309
Practice Address - Street 1:650 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1799
Practice Address - Country:US
Practice Address - Phone:603-357-1748
Practice Address - Fax:603-355-1309
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99002103Medicaid