Provider Demographics
NPI:1851518930
Name:MATHIAS, CRAIG (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:MATHIAS
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1221
Mailing Address - Country:US
Mailing Address - Phone:717-233-6739
Mailing Address - Fax:717-232-8898
Practice Address - Street 1:2721 N FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1221
Practice Address - Country:US
Practice Address - Phone:717-233-6739
Practice Address - Fax:717-232-8898
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024372L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics