Provider Demographics
NPI:1609048552
Name:BLUCHER, CRAIG (DDS)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:BLUCHER
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 1:4920-A WATERLOO ROAD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-6651
Mailing Address - Country:US
Mailing Address - Phone:410-750-7855
Mailing Address - Fax:410-203-9435
Practice Address - Street 1:4920 WATERLOO ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-6689
Practice Address - Country:US
Practice Address - Phone:410-750-7855
Practice Address - Fax:410-203-9435
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD72231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice