Provider Demographics
NPI:1285638833
Name:HOVICK, CRAIG J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:J
Last Name:HOVICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 17TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-2647
Mailing Address - Country:US
Mailing Address - Phone:303-678-5253
Mailing Address - Fax:303-678-1054
Practice Address - Street 1:1055 17TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-2647
Practice Address - Country:US
Practice Address - Phone:303-678-5253
Practice Address - Fax:303-678-1054
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1054181223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics