Provider Demographics
NPI:1750029112
Name:CRAIG A. BIRCH, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:CRAIG A. BIRCH, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ARLEN
Authorized Official - Last Name:BIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-379-9322
Mailing Address - Street 1:21969 HURON RIVER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:48173-1237
Mailing Address - Country:US
Mailing Address - Phone:734-379-9322
Mailing Address - Fax:734-379-8932
Practice Address - Street 1:21969 HURON RIVER DR
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:MI
Practice Address - Zip Code:48173-1237
Practice Address - Country:US
Practice Address - Phone:734-379-9322
Practice Address - Fax:734-379-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1215066279OtherNPI