Provider Demographics
NPI:1922232750
Name:SHECTER, CRAIG ALAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:SHECTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 BAIRD RD.
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066
Mailing Address - Country:US
Mailing Address - Phone:610-716-5254
Mailing Address - Fax:610-664-2220
Practice Address - Street 1:312 BAIRD RD.
Practice Address - Street 2:
Practice Address - City:MERION STA.
Practice Address - State:PA
Practice Address - Zip Code:19066
Practice Address - Country:US
Practice Address - Phone:610-716-5254
Practice Address - Fax:610-664-2220
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018875L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist