Provider Demographics
NPI:1811041171
Name:CRAIG L. MEADOWS, DDS, PLLC
Entity Type:Organization
Organization Name:CRAIG L. MEADOWS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-267-3928
Mailing Address - Street 1:111 TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-2841
Mailing Address - Country:US
Mailing Address - Phone:304-267-3928
Mailing Address - Fax:304-267-4618
Practice Address - Street 1:111 TAVERN RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2841
Practice Address - Country:US
Practice Address - Phone:304-267-3928
Practice Address - Fax:304-267-4618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty