Provider Demographics
NPI:1548388960
Name:CRAFTON, LISA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:S
Last Name:CRAFTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 LELAND ST
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6048
Mailing Address - Country:US
Mailing Address - Phone:301-657-7829
Mailing Address - Fax:
Practice Address - Street 1:10380 OLD COLUMBIA RD STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2005
Practice Address - Country:US
Practice Address - Phone:410-381-0900
Practice Address - Fax:410-381-7960
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice