Provider Demographics
NPI:1346498722
Name:STEICHEN, CRAIG T (DDS)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:T
Last Name:STEICHEN
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 1:7131 PROSPECT PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4313
Mailing Address - Country:US
Mailing Address - Phone:505-883-6562
Mailing Address - Fax:505-883-8634
Practice Address - Street 1:7131 PROSPECT PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4313
Practice Address - Country:US
Practice Address - Phone:505-883-6562
Practice Address - Fax:505-883-8634
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD1629332BC3200X
NM1629122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1326181587OtherTYPE 2 NPI #