Provider Demographics
NPI:1255676987
Name:MCCRACKEN, GERALDINE C (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:C
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4328
Mailing Address - Country:US
Mailing Address - Phone:717-737-8423
Mailing Address - Fax:717-737-2351
Practice Address - Street 1:3801 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4328
Practice Address - Country:US
Practice Address - Phone:717-737-8423
Practice Address - Fax:717-737-2351
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026556L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist