Provider Demographics
NPI:1497845226
Name:TRUEBLOOD, CRAIG ARTHUR (DDS)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:ARTHUR
Last Name:TRUEBLOOD
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 1:375 S VULTURE MINE RD
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-2106
Mailing Address - Country:US
Mailing Address - Phone:928-684-7520
Mailing Address - Fax:
Practice Address - Street 1:375 S VULTURE MINE RD
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-2106
Practice Address - Country:US
Practice Address - Phone:928-684-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice