Provider Demographics
NPI:1831310978
Name:MYRMEL, CRAIG A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:MYRMEL
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 1:1701 E THOMAS RD
Mailing Address - Street 2:STE 204
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7675
Mailing Address - Country:US
Mailing Address - Phone:602-253-6600
Mailing Address - Fax:602-733-6480
Practice Address - Street 1:2855 E BROWN RD
Practice Address - Street 2:SUITE 15
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-4213
Practice Address - Country:US
Practice Address - Phone:480-807-2636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist