Provider Demographics
NPI:1558616847
Name:BAIR, CRAIG SAMUEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:SAMUEL
Last Name:BAIR
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 1:515 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1923
Mailing Address - Country:US
Mailing Address - Phone:610-409-1940
Mailing Address - Fax:610-409-1941
Practice Address - Street 1:515 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-1923
Practice Address - Country:US
Practice Address - Phone:610-409-1940
Practice Address - Fax:610-409-1941
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0386051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry