Provider Demographics
NPI:1366455297
Name:DAN D. CRAIGE, D.D.S., INC.
Entity Type:Organization
Organization Name:DAN D. CRAIGE, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-924-2206
Mailing Address - Street 1:203 N 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-3607
Mailing Address - Country:US
Mailing Address - Phone:580-924-2206
Mailing Address - Fax:580-924-2215
Practice Address - Street 1:203 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-3607
Practice Address - Country:US
Practice Address - Phone:580-924-2206
Practice Address - Fax:580-924-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4102122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty