Provider Demographics
NPI:1942301502
Name:CRAIG, JIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:JIM
Middle Name:
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:14991 E HAMPDEN AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3996
Mailing Address - Country:US
Mailing Address - Phone:303-693-1215
Mailing Address - Fax:303-693-6452
Practice Address - Street 1:14991 E HAMPDEN AVE STE 370
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3996
Practice Address - Country:US
Practice Address - Phone:303-693-1215
Practice Address - Fax:303-693-6452
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice