Provider Demographics
NPI:1215197595
Name:CRANHAM, JOHN C (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:CRANHAM
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 RAINTREE RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3700
Mailing Address - Country:US
Mailing Address - Phone:757-465-8900
Mailing Address - Fax:757-488-7365
Practice Address - Street 1:4016 RAINTREE RD
Practice Address - Street 2:SUITE 320
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3700
Practice Address - Country:US
Practice Address - Phone:757-465-8900
Practice Address - Fax:757-488-7365
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist