Provider Demographics
NPI:1740390814
Name:HUNTER, CRAIG JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:JOHN
Last Name:HUNTER
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 1:1367 ELIZA ST
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53530-1062
Mailing Address - Country:US
Mailing Address - Phone:608-226-2620
Mailing Address - Fax:
Practice Address - Street 1:3528 MEACHEM RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53405-4662
Practice Address - Country:US
Practice Address - Phone:608-226-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2752122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33428900Medicaid