Provider Demographics
NPI:1366679870
Name:KRAFT, CHRISTINA MARIE (DMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:KRAFT
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 1:4356 N RIO CANCION
Mailing Address - Street 2:APT 303
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-7173
Mailing Address - Country:US
Mailing Address - Phone:215-834-7898
Mailing Address - Fax:
Practice Address - Street 1:9660 E 22ND ST
Practice Address - Street 2:#160
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-7561
Practice Address - Country:US
Practice Address - Phone:520-719-0666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD77681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice