Provider Demographics
NPI:1013939586
Name:FRIEDMAN, CRAIG ALAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:FRIEDMAN
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 1:4745 SW 148TH AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33330-2126
Mailing Address - Country:US
Mailing Address - Phone:954-349-3449
Mailing Address - Fax:954-349-4462
Practice Address - Street 1:4745 SW 148TH AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33330-2126
Practice Address - Country:US
Practice Address - Phone:954-349-3449
Practice Address - Fax:954-349-4462
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN151531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice