Provider Demographics
NPI:1346219110
Name:CRAFT, STEPHEN ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALLEN
Last Name:CRAFT
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 1:274 N EL CAMINO REAL
Mailing Address - Street 2:STE. D
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2859
Mailing Address - Country:US
Mailing Address - Phone:760-436-5580
Mailing Address - Fax:
Practice Address - Street 1:274 N EL CAMINO REAL
Practice Address - Street 2:STE. D
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2859
Practice Address - Country:US
Practice Address - Phone:760-436-5580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA369081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice