Provider Demographics
NPI:1467013060
Name:MADISON, CRAIG JOSEPH (DMD)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:JOSEPH
Last Name:MADISON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 CRATER LAKE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43085-1504
Mailing Address - Country:US
Mailing Address - Phone:412-551-2831
Mailing Address - Fax:
Practice Address - Street 1:625 CHERRY TREE LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8419
Practice Address - Country:US
Practice Address - Phone:724-437-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARES.0041451223X0400X
PADS0438241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics